Harassment, intimidation or bullying (HIB)

Harassment, intimidation or bullying (HIB) Form

Required

Harassment, intimidation or bullying means any intentional electronic, written, verbal, auditory or physical act, including, but not limited to one shown to be motivated by any characteristic or race, color, religion, ancestry, national origin, gender, sexual orientation, including gender expression or identity, mental or physical disability or other distinguishing characteristics such as, but not limited to, physical appearance, clothing or other apparel, socioeconomic status, marital status or weight, when the intentional electronic, written, verbal, auditory or physical act:

  • Physically harms a student; or
  • damages the student’s property; or
  • has the effect of substantially interfering with a student’s education; or
  • is so severe, persistent or pervasive that it creates an intimidating or threatening educational environment; or
  • has the effect of substantially disrupting the orderly operation of the school.

If you believe that an incident of harassment, intimidation or bullying is and/or has taken place against a student in the educational environment, please complete the document below.

Alleged Aggressor(s)required
Targeted Students(s)required
Your Name
Your Phone
Your Email
School adult you've already contacted (if any)
Witnesses of the incident (if any)
School where incident(s) happenedrequired
Date(s) the incident happened (if known)
Must contain a date in M/D/YYYY format
Area where the incident(s) happenedCheck all that apply:​​
Check all that apply:​​
Specify locations
What the aggressor didCheck all that apply:​
Check all that apply:​
Specify Values
Physical injuries resulting from incidentCheck all that apply:​
Check all that apply:​
Specify Injuries
Number of days targeted student(s) was absent from school as a result (if any)
Why do you think the harassment, intimidation or bullying occurred?required
Any additional information you'd like to share

Additional Questions?

Elementary
Christa Erolin
(253) 571-1318

Secondary
Wayne A. Greer
(253) 571-1319