District Bullying or Harassment Formal Complaint Form
0115_E.1 Bullying or Harassment Formal Complaint Form.pdf
Name of Complainant
Date of Complaint
Name of person alleged of bullying or harassing
Date and place of incident
Description of incident
Name(s) of witness(s) (if any)
Has an incident with the same person been reported before?
If yes, when? To whom?
What was the resolution?
Signature of Complainant:
Signature of Person Receiving This Complaint
Board Approval Date: September 16, 2015