Harassment Intimidation & Bullying

Stanwood-Camano School District Reporting Form

This form is used to file official Harassment, Intimidation, or Bullying (HIB) complaints that meet the definition of HIB OR to notify administrators or concerns do not meet the definition of HIB.

Definition of Harassment, intimidation, or bullying (HIB):

Harassment, intimidation, or bullying means an intentional electronic, written, verbal, or physical act that:

Physically harms a student or damages the student’s property;
Has the effect of substantially interfering with a student’s education;
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.

Conduct that “has the effect of substantially interfering with a student’s education” will be determined by considering a targeted student’s grades, attendance, demeanor, interaction with peers, participation in activities, and other indicators.

If the situation does not meet the definition of HIB, please consider reporting an incident and an administrator will help.

Please complete the form below.

Please indicate the type of report you are makingrequired

I have an incident to report

I want to report Harassment, Intimidation, or Bullying

Incident Reporting

Please complete this form to help a school administrator address the situation.

Individuals may file a report without revealing their identity, per school board policy. No disciplinary action will be taken against an alleged perpetrator based solely on an anonymous report. Schools may use complaint boxes or develop other methods for receiving anonymous, unsigned reports.

Name of person completing this form

First Name

Last Name

Name of student you are completing this form on behalf of

First Name

Last Name

Your email address

Name of anyone at the school you have already contacted (if any)

Please describe the incident in detail. This should include students/staff involved, dates, witnesses, etc.required0 / 1000

This form is used only to file official HIB complaints that meet the definition.

Please note that many issues or concerns do not meet the definition of HIB.

For other non-HIB incidents or concerns please contact to your school’s administrator to address the situation rather than completing this form.

Do you feel the incident you are reporting qualifies as HIB based on the definition and criteria?required

Yes

No

HIB Reporting Form

Please complete this form to file an official Harassment, Intimidation, or Bullying (HIB) complaint.

Individuals may file a report without revealing their identity, per school board policy and procedure. No disciplinary action will be taken against an alleged perpetrator based solely on an anonymous report. Schools may use complaint boxes or develop other methods for receiving anonymous, unsigned reports.

Name of victim

First Name

Last Name

Name of person completing this form

First Name

Last Name

Name of anyone at the school you have already contacted (if any)

First Name

Last Name

Your phone number

Name of offender (if known)

First Name

Last Name

Date of incident

Must contain a date in M/D/YYYY format

Names of any witnesses

Please describe the incident that qualifies as harassment, intimidation, or bullying (HIB)required0 / 1000

Consider incident reporting

Please restart this form to submit this situation as an incident or seek help a school administrator to address the situation.

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In This Section

In This Section

Stanwood-Camano School District site HIB contacts

Stanwood-Camano School District HIB Policy and Procedure

Online Reporting Form

Stanwood-Camano School District Reporting Form

Incident Reporting

This form is used only to file official HIB complaints that meet the definition.

Please note that many issues or concerns do not meet the definition of HIB.

HIB Reporting Form

Consider incident reporting

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Links & Resources