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5517.01 F1/page 1 of 2 BULLYING/HARASSMENT AND INTIMIDATION COMPLAINT AND INVESTIGATION School # Date of Complaint: Date parents notified of complaint (both complainant and alleged violator) Complainant:
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How to fill out bullyingharassment and intimidation complaint

How to Fill Out a Bullying, Harassment, and Intimidation Complaint:
Begin by gathering all relevant information:
01
Name and contact information of the complainant (person filing the complaint)
02
Name(s) of the alleged perpetrator(s)
03
Dates, times, and locations of the incidents
04
Detailed description of the incidents, including any witnesses
Consult your organization's policies and procedures:
01
Familiarize yourself with the guidelines and requirements for filing a complaint
02
Determine the appropriate form or format for submitting the complaint
03
Note any deadlines or specific instructions mentioned in the policies
Start filling out the complaint form:
01
Provide your personal information as the complainant, including your name, contact details, and any relevant affiliations with the organization
02
Clearly identify the alleged perpetrator(s), providing their names, contact information if available, and any additional details that can help in their identification
Describe the incidents in detail:
01
Use a chronological order to outline each incident, providing the dates, times, and locations
02
Describe what happened during each incident, including any specific actions, words, or behaviors that constitute bullying, harassment, or intimidation
03
Include any relevant evidence or documentation, such as emails, text messages, or photographs, if available
Include information about witnesses:
01
If there were any witnesses to the incidents, provide their names and contact information
02
Briefly describe their involvement and any statements they may have made regarding the incidents
Sign and date the complaint:
01
Review the completed form to ensure all information is accurate and complete
02
Sign the form and date it to indicate when the complaint was filed
03
If required, make a copy of the complaint for your records before submitting it
Who Needs a Bullying, Harassment, and Intimidation Complaint?
Anyone who has experienced or witnessed bullying, harassment, or intimidation can file a complaint. This includes:
01
Employees or workers who have experienced mistreatment in the workplace, such as from colleagues, superiors, or clients.
02
Students who have been subjected to bullying, harassment, or intimidation by other students, teachers, or staff members within a school or educational institution.
03
Members of an organization or community who have been victims of bullying, harassment, or intimidation by fellow members, leaders, or individuals affiliated with the organization.
04
Individuals who have experienced any form of bullying, harassment, or intimidation in public spaces, such as public transportation, parks, or social gatherings.
It is important to note that the specific requirements for filing a complaint may vary depending on the organization or institution in question. Therefore, it is advisable to refer to the relevant policies and procedures or seek guidance from appropriate authorities to ensure the complaint is properly filed.
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