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North Kitsap School District

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Discrimination/Harassment/504 Incident report/title IX Complaint Form


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This form is designed to compile complaints related to harassment or discrimination, serving as a primary resource for initial fact-finding investigations.

Discrimination refers to individuals' unjust or prejudiced treatment or the denial of equal access to educational, employment, or workplace opportunities.

Harassment encompasses any behavior or environmental factor that negatively or stereotypically targets a person based on age, race, gender, color, creed, national origin, sexual orientation, religion, marital status, disability, or public assistance status.

Personal Information

Must contain a date in M/D/YYYY format
Your Namerequired
First Name
Last Name

Incident Details

0 / 3000
0 / 300
Was anyone injured? required
0 / 3000
Was property damaged?required
0 / 3000

Additional Information

Have you told anyone within the school or department?
0 / 3000
Would you like someone to help you with this issue (an advocate)?
0 / 3000

Report Status

Status of Report (please select one):required

Upon submission, this online form will be sent to both the North Kitsap School District’s Harassment, Intimidation, and Bullying Compliance Office and the North Kitsap School District's Title IX Compliance Office.

Please be assured that retaliation against anyone who files a complaint or participates in the complaint process is strictly prohibited. Your school district is committed to resolving complaints promptly and thoroughly. If immediate, clear, and potential physical harm is present, the district will contact law enforcement and inform the parent/guardian.