Bullying Incident Reporting Form

  • The Bullying Incident Reporting Form provides a way for anyone to report instances of harassment, bullying, and/or discrimination against students either in school or out of school, and to do so anonymously if they choose. This form may be used by:
     
    • Students who have been subjected to harassment, bullying, and/or discrimination
    • Parents/guardians whose children have been subjected to harassment, bullying, and/or discrimination
    • Anyone who has observed or has been told of harassment, bullying, and/or discrimination against a student or students
     
    This information is confidential and will be shared with the school principal, Dignity Act Coordinator, and (for incidents involving a student or students at the high school level) the School Resource Officer for immediate investigation and follow-up. Please provide as much information as you can so that the problem can be addressed directly.
     
    False reporting of an incident is against state law and school policy. Section 240.50 of the New York State Penal Law states: A person is guilty of falsely reporting an incident when, knowing the information reported, conveyed or circulated to be false or baseless, he/she initiates a false report or warning of an alleged occurrence or impending occurrence of a crime, catastrophe or emergency under circumstances in which it is not unlikely that public alarm or inconvenience will result. This is a Class A Misdemeanor.
     
Last Modified on August 5, 2018