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Otsego Elementary School Faculty Handbook - Half Hollow Hills

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HALF HOLLOW HILLS CENTRAL SCHOOL DISTRICT<br />

525 HALF HOLLOW ROAD<br />

DIX HILLS, NY 11746<br />

Hazing, Initiation Activities, Harassment and Bullying Complaint Form<br />

Hazing, initiation activities, harassment and bullying are abusive and often illegal<br />

behaviors that harm victims and negatively impact school environment by creating an<br />

atmosphere of fear, distrust, mean-spiritedness, intimidation and intolerance.<br />

Individual Filing Complaint:<br />

Name____________________________________<br />

Position/Title______________________________<br />

Date of Complaint__________________________<br />

Complaint Filed Against:<br />

Name____________________________________<br />

Position/Title______________________________<br />

Date and Place of Incident_________________________________________________________<br />

______________________________________________________________________________<br />

Description of event(s) which caused you to file this complaint. Please give dates and all relevant<br />

information in sequential order. Attach any evidence._________________________________________<br />

Name of Witness(es) [if any]: ___________________________________________________________<br />

____________________________________________________________________________________

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