MTSD Harassment/Intimidation/ Bullying Report
A member of a Board of Education, a school staff member, or a student who has witnessed, or has reliable information that a student has been subject to, harassment, intimidation or bullying shall report the incident to the appropriate school official designated by the school district's policy, or to any school administrator or safe schools resource officer, who shall immediately initiate the school district’s procedures concerning school bullying. ALL MTSD stakeholders are asked to report all incidents as well!

A member of a Board of Education or a school employee who promptly reports an incident of harassment, intimidation or bullying, to the appropriate school official designated by the school district's policy, or to any school administrator or safe schools resource officer, and who makes this report in compliance with the procedures in the district's policy, is immune from a cause of action for damages arising from any failure to remedy the reported incident.

Anyone who files a report/claim he/she knows to be false will be held responsible and reported to an appropriate law enforcement agency for processing. Under no circumstances will false reports ever be considered "a joke" or "minor mischief." They will be immediately reported.

Please complete the form below.

What is the victim's name?*
Your answer
What is the alleged bully's name?*
Your answer
On what date did the alleged HIB incident occur?*
Date
Which MTSD school do those involved in the incident attend?*
I am a ...*
I know about this incident because...*
Did anyone else witness these alleged behaviors? Please provide names.*
Your answer
Please check all the HIB behaviors you are reporting.*
Required
The alleged incident took place...*
Required
How long do you suspect this HIB has been going on?*
Your answer
Please write a short summary of the incident. Include the alleged bully's name and location of the incidents.*
Your answer
I can be reached at (phone number, email address) -- optional.
Your answer
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