Incident Report Form

A safe and civil environment is needed for students to learn and attain high academic standards and to promote healthy human relationships. Acts of bullying and harassment interferes with a student’s ability to learn and/or a teacher’s ability to educate students in a safe environment.  An act of bullying or harassment, by either an individual student or a group of students, is expressly prohibited on school premises, on school district property, at school functions or activities, or on school transportation.

The school district will act to investigate all allegations reported to the school district and will discipline or take appropriate action against any student, teacher, administrator, volunteer, contractor, or other employee of the school district who is found to have violated this policy.  The following terms and reporting procedures are taken from Eastern Carver County Schools Board Policy 

  • 514: Bullying Prohibition 

  • 413: Harassment and Violence Prohibition Policy

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“Bullying”

“Bullying” means intimidating, threatening, abusive, or harming conduct that is objectively offensive and: 

  1. an actual or perceived imbalance of power exists between the student engaging in the prohibited conduct and the target of the prohibited conduct, and the conduct is repeated or forms a pattern; or 
  2. materially and substantially interferes with a student’s educational opportunities or performance or ability to participate in school functions or activities or receive school benefits, services, or privileges.
Race-based harassment, bullying, or discrimination”

Race-based harassment, bullying, or discrimination” include any physical or verbal conduct, including, but not limited to, electronic communications, relating to race which 

  1. has the purpose or effect of creating an intimidating, hostile, or offensive working or academic environment for School District students and/or School District personnel; 
  2. has the purpose or effect of substantially or unreasonably interfering with the work or academic performance of School District students and/or School District personnel; or 
  3. otherwise adversely affects employment or educational opportunities within the School District for School District students and/or School District personnel. Examples of race-based harassment, bullying, or discrimination, include but are not limited to the following: 
  • Unwelcome verbal harassment or abuse, including teasing, joking, or making derogatory or dehumanizing remarks; 
  • Displaying offensive pictures, posters, apparel and accessories, or other graphics; 
  • Threats or actions related to an individual’s race, religion, or ethnic heritage; 
  • Unwelcome physical contact, other than necessary restraint of pupil(s) by teachers, administrators, or other school personnel to avoid physical harm to persons or property; and 
  • Physical violence or abuse. 
“Cyberbullying”
“Cyberbullying” means bullying using technology or other electronic communication, including, but not limited to, a transfer of a sign, signal, writing, image, sound, or data, including a post on a social network Internet website or forum, transmitted through a computer, cell phone, or other electronic device. The term applies to prohibited conduct which occurs on school premises, on school district property, at school functions or activities, on school transportation, or on school computers, networks, forums, and mailing lists, or off school premises to the extent that it substantially and materially disrupts student learning or the school environment. 
“Intimidating, threatening, abusive, or harming conduct”

“Intimidating, threatening, abusive, or harming conduct” means, but is not limited to, conduct that does the following: 

  1. Causes physical harm to a student or a student’s property or causes a student to be in reasonable fear of harm to person or property; 
  2. Under Minnesota common law, violates a student’s reasonable expectation of privacy, defames a student, or constitutes intentional infliction of emotional distress against a student; or 
  3. Is directed at any student or students, including those based on a person’s actual or perceived race, ethnicity, color, creed, religion, national origin, immigration status, sex, marital status, familial status, socioeconomic status, physical appearance, sexual orientation including gender identity and expression, academic status related to student performance, disability, or status with regard to public assistance, age, or any additional characteristic defined in the Minnesota Human Rights Act (MHRA). However, prohibited conduct need not be based on any particular characteristic defined in this paragraph or the MHRA.
“Assault” 

“Assault” is:

  1. an act done with intent to cause fear in another of immediate bodily harm or death;
  2. the intentional infliction of or attempt to inflict bodily harm upon another; or
  3. the threat to do bodily harm to another with present ability to carry out the threat.
“Harassment”

“Harassment” prohibited by this policy consists of physical or verbal conduct, including, but not limited to, electronic communications, relating to an individual’s or group of individuals’ race, color, creed, religion, national origin, sex, age, marital status, familial status, status with regard to public assistance, sexual orientation, including gender identity or expression, or disability when the conduct:

  1. has the purpose or effect of creating an intimidating, hostile, or offensive working or academic environment;
  2. has the purpose or effect of substantially or unreasonably interfering with an individual’s work or academic performance; or
  3. otherwise adversely affects an individual’s employment or academic opportunities.
District Administrative Contacts

District Administrative Contacts

District Education Center 

11 Peavey Rd, Chaska, MN 55318


Eastern Carver County Human Rights Officers

  • Director of Human Resources (952-556-6251) 
  • Assistant Superintendent (952-556-6114) 

Eastern Carver County Schools Title IX Coordinator

  • Student Services Administrator (952-556-6141)


How is this Report being provided *
Written Report - Report filled out by a witness or target of the incident
Oral Report - Report filled out by 3rd party who was provided information regarding the incident
Do you want to Make an Anonymous Report  *
By clicking "No", you will be asked for your Name and Contact information. If you would like to make an anonymous report, select "Yes", your contact information will not be recorded
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