For official copies of board policies and procedures please contact the superintendent's office at (253) 583-5190 or email

Link to Policy 3207
Link to Procedure 3207-P1

For more information about Form 3207-F1 please contact the Director of Student Services at 253-583-5154

Harassment, Intimidation or Bullying (HIB) Incident Reporting Form
  1. Please print, complete, and return this form to the principal.
  2. No disciplinary action will be taken against an alleged perpetrator based soley on anonymous reporting




(if any):

Name(s) of alleged aggressor(s) if known (the bully):

On what dates did the incident(s) happen: (if known):

Where did the incident(s) happen (if known):

Please check the box that best describes what the bully did. Please choose all that apply.

If you selected other, please describe:

Why do you think the harassment, intimidation or bullying occurred?

Were there any witnesses? If yes, please provide their names:

Did a physical injury result from this incident? If yes, please describe.

Was the targeted student absent from school as a result of the incident? If yes, please describe:

Is there any additional information?

Thank you for reporting!

For Office Use

Check one:

Referred to: