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Bully Report Form (no longer being used)

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“Bullying” means a single significant act or a pattern of acts by one or more students directed at another student that exploits an imbalance of power and involves engaging in written or verbal expression, expression through electronic means, or physical conduct, and that

 

  • has the effect or will have the effect of physically harming a student, causing a student to experience substantial negative mental health effects, damaging a student's property, or placing a student in reasonable fear of harm to the student's person or of damage to the student's property;

  • is sufficiently severe, persistent, and pervasive enough that the action or threat creates an intimidating, threatening, or abusive educational environment for a student;

  • materially and substantially disrupts the educational process or the orderly operation of a classroom or school; or

  • infringes on the rights of the victim at school; and

 

"Cyberbullying" means bullying that is done through the use of electronic communication, including through the use of a cellular or other type of telephone, a computer, a pager, a camera, electronic mail, instant messaging, text messaging, a social media application, Internet website, or other Internet-based communication tool.

 

If the incident took place in a classroom, was the classroom supervised?*
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What did the bully do specifically? (Check all that you saw happening during the incident.):*
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