This form is to be confidentially maintained in accordance with the Family Educational Rights and Privacy Act, 20 U.S.C. § 1232g.
Directions: Harassment and bullying are serious and will not be tolerated. If you are a student, the parent/guardian of a student, a volunteer or visitor, and wish to report an incident of alleged harassment and/or bullying, complete and submit this form. Upon submission the Principal at the student’s school will be notified. All school employees are required to report alleged violations. Contact the school for additional information or assistance at any time. This form can be completed anonymously by omitting the "Name of Person Reporting the Incident" field.
Every reported act of bullying or harassment will be investigated, and parents will be informed.
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