Dignity for All Students - Reporting Form
The Dignity for All Students Act (DASA) puts in place procedures for the creation of school environments free of discrimination and harassment.  The law is effective July 1, 2012.  “The legislature finds and Gananda supports that students’ ability to learn and to meet high academic standards and the school’s ability to educate its students, are compromised by incidents of discrimination or harassment including bullying, taunting or intimidation.”
 
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DIRECTIONS:
Discrimination and harassment are serious offenses and will not be tolerated.  Please use this form to report alleged discrimination and/or harassment, that occurred on school property, at a school sponsored activity or event, on a school bus, or on the way to and/or from school.  Any person (student, parent/caregiver, community member, faculty/staff member etc.) observing, or being the target of discrimination or harassment or perceived discrimination or harassment activity reports the observation.  Please complete and submit this form that will be shared with our DASA Coordinator.  Contact the school for additional information or assistance. 

This form may be completed anonymously, but doing so may limit the follow up that can occur.
PERSON REPORTING INCIDENT
Name:
Email:
Telephone Number
Relationship to target?
Clear selection
Did you witness the incident? *
Date of incident?
MM
/
DD
/
YYYY
Approximate time of incident?
Time
:
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