Bullying Reporting Form
If you believe you have been the victim of bullying or you know someone who has, use the form below to report the incident(s). Though you may include your name and contact information at the top of the form, you may also choose not to.

''Bullying'', the repeated use by one or more students or by a member of a school staff including, but not limited to, an educator, administrator, school nurse, custodian, bus driver, or paraprofessional of a written, verbal or electronic expression or a physical act or gesture or any combination thereof, directed at a victim that: (i) causes physical or emotional harm to the victim or damage to the victim's property; (ii) places the victim in reasonable fear of harm to himself or of damage to his property; (iii) creates a hostile environment at school for the victim; (iv) infringes on the rights of the victim at school; or (v) materially and substantially disrupts the education process or the orderly operation of a school. For the purposes of this section, bullying shall include cyber-bullying.

"Aggressor'', a student or a member of a school staff including, but not limited to, an educator, administrator, school nurse, cafeteria worker, custodian, bus driver, or paraprofessional who engages in bullying or retaliation.

Cyber-bullying is defined as bullying through the use of technology or any electronic communication, which shall include but is not limited to electronic mail, internet communications, instant messaging, posting on social networking sites, or facsimile communications.
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Name of Reporter/Person Filing the Report (optional)

Note: An anonymous reports will prompt an investigation; disciplinary action will not be taken solely on the information in an anonymous claim
Check whether you are the: *
Check whether you are a: *
Below, list your phone number or email address (optional)
If you are a parent/guardian, student, or staff member, check the appropriate program: *
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