Talladega City Schools Bullying Prevention Complaint Form

Talladega City Schools Bullying Prevention Complaint Form
Student Name*

First NameLast Name
Parent/Guardian Name

First NameLast Name
Email*
example@example.com
Phone Number*
School Name*
Infraction Reported By*

StudentParent/Guardian
Date of Incident*

MonthDayYear
Date
Time Incident Occured

Hour Minutes

AM/PM Option
Specific Location of Incident*
Description of Incident*
The Jamari Terrell Williams Student Bullying Prevention Act, No. 2018-472, defines bullying as a continuous pattern of intentional behavior that takes place on school property, on a school bus, or at a school-sponsored function including, but not limited to, cyberbullying, written, electronic, verbal, or physical acts that are reasonably perceived as being motivated by any characteristic of a student, or by the association of a student with an individual who has a particular characteristic, if the characteristic falls into one of the categories of personal characteristics contained in the policy adopted by the local board. To constitute bullying, a pattern of behavior may do any of the following:

Place a student in reasonable fear of harm to his or her person or damage to his or her property.

Have the effect of substantially interfering with the educational performance, opportunities, or benefits of a student.

Have the effect of substantially disrupting or interfering with the orderly operation of the school.

Have the effect of creating a hostile environment in the school, on school property, on a school bus, or at a school-sponsored function.
Have the effect of being sufficiently severe, persistent, or pervasive enough to create an intimidating, threatening, or abusive educational environment for a student.
Should be Empty: