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District Bullying Form

“Bullying” means intimidating, threatening, abusive, or harming conduct that is objectively offensive and: 1. An actual or perceived imbalance of power exists between the student engaging in the prohibited conduct and the target of the prohibted conduct, and the conduct is repeated or forms a pattern; or 2. Materially and substantially interferes with a student's educational opportunities or performance or ability to participate in school functions or activities or receive school benefits, services or privileges.

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At What School Did the Incident Occur?*
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Person Submitting Complaint is a:*
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Time of Incident*
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Where did Incident Occur?*
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Type of Incident*
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