Gates Middle School Bullying, Bias, Discrimination & Harassment Reporting Form
The Scituate Public Schools is committed to providing a safe, positive and productive educational environment where students can achieve the highest academic standards. No student shall be subjected to harassment, intimidation, bullying, or cyber-bullying. Please use the form below to report instances of bullying.

Bullying is the repeated use of a written, verbal, or electronic expression, or a physical act or gesture, or any combination thereof, directed at a target that:

• causes physical or emotional harm to the target or damage to the target's property;

• places the target in reasonable fear of harm to him/herself, or of damage to his/her property;

• creates a hostile environment at school for the target;

• infringes on the rights of the target at school; or

• materially and substantially disrupts the education process or the orderly operation of a school.

"Cyber-bullying" means bullying through the use of technology or any electronic communication. Cyber-bullying shall also include the creation of a web page or blog in which the creator assumes the identity of another person or knowingly impersonates another person as author of posted content or messages, if the creation or impersonation creates any of the conditions enumerated in the definition of bullying.

Cyber-bullying shall also include the distribution by electronic means of a communication to more than one person or the posting of material on an electronic medium that may be accessed by one or more persons, if the distribution or posting creates any of the conditions enumerated in the definition of bullying.

Bullying and cyber-bullying may occur in and out of school, during and after school hours, at home and in locations outside of the home. When bullying and cyber-bullying are alleged, the full cooperation and assistance of parents and families are expected.

Bullying and cyber-bullying are prohibited at a location, activity, function or program that is not school-related or through the use of technology or an electronic device that is not owned, leased or used by the Scituate Public Schools if the act or acts in question:

• create a hostile environment at school for the target;

• infringe on the rights of the target at school; and/or

• materially and substantially disrupt the education process or the orderly operation of a school.
What is your name? (This line may be left blank if an anonymous report is being made. Reports may be made anonymously, but no disciplinary action will be taken against an alleged aggressor solely on the basis of an anonymous report).
What is your email address? (This line may be left blank if an anonymous report is being made.)
What is your role?
Clear selection
What is the name of the person, people, or group that was allegedly targeted in this incident?
What is the name of the alleged perpetrator(s) in this incident?
What are the names of those individuals that witnessed this incident?
Please describe the details of the incident, be as specific as possible (date, location, what happened). Please describe any documents or evidence that you have available (screenshots, etc.).
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