incident report

Bullying, Harassment, or Intimidation Incident Reporting


The Dignity for All Student’s Act ensures that each school in New York State has a plan to both prevent and
respond to harassment, intimidation, and bullying. The Bemus Point Central School District has updated school
protocols and response systems to ensure a safe environment for all students, staff, parents, and community
members where students are ready to learn.

The Bemus Point Central School District believes that bullying, harassment, and intimidation are serious and will
not be tolerated. The form below is provided for you to inform the school about any situation or problem that
you are having, or know information about, regarding bullying or harassment. Please complete this form if you
are a victim or have witnessed an incident of bullying, harassment, or intimidation.

Your information will be kept confidential and will be seen only by the District Dignity for All School’s Act
Coordinators and building administrators (if appropriate).
• District Dignity for All Student’s Coordinator – Mary Osgood (School Psychologist)
• Maple Grove Jr/Sr. High School Dignity for All Student’s Coordinator – Kelly Filkins (Guidance
Counselor)
• Bemus Point Elementary Dignity for All Student’s Coordinator – Cheryl Russo (Guidance Counselor)

Please report as much information as you can so that the problem can be effectively addressed.

Click on the link below to fill out the report.

Note: 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, know the information is 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.”

Fill out a Bullying, Harassment, or Intimidation Reporting Form

Definitions:
• Bullying: any unwanted, aggressive behavior that involves a real or perceived power imbalance.
Bullying generally involves the following characteristics:
o An Imbalance of Power: Children who bully use their power, such as physical strength, access
to embarrassing information, or popularity, to control or harm others. Power imbalances can
change over time and in different situations, even if they involve the same people.
o Intent to Cause Harm: The person bullying has the goal of causing harm
o Repetition: Bullying behaviors generally happen more than once or have the potential to
happen more than once.

Examples of bullying include, but are not limited to:
o Verbal: Name-calling, teasing, inappropriate sexual comments, taunting, and threatening to
cause harm.
o Social: Spreading rumors about someone, excluding others on purpose, telling other children
not to be friends with someone, and embarrassing someone in public.
o Physical: Hitting, punching, shoving, kicking, pinching, spitting, tripping, pushing, taking or
breaking someone’s things, and making mean or rude hand gestures.

Harassment: the creation of a hostile environment by
o Conduct, verbal threats, intimidations or abuse that has or would have the effect of
unreasonably and substantially interfering with a student’s educational performance,
opportunities or benefits, or mental, emotional or physical well-being; or
o conduct, verbal threats, intimidations or abuse that reasonably or would reasonably be
expected to cause a student to fear for his or her physical safety.