RCAS Report of a Bullying Incident
This is a report to gather important information to facilitate an appropriate investigation of a suspected bullying incident. We appreciate the information you are about to provide.
BULLYING is a pattern of repeated conduct that causes physical hurt or psychological distress on one or more students that may include threats, intimidation, stalking, physical violence, theft, destruction of property, any threatening use of data or computer software, written or verbal communication, or conduct directed against a student that:
1. Places a student in reasonable fear of harm to his or her person or damage to his or her property; and either
2. Substantially interferes with a student’s educational performance; or
3. Substantially disrupts the orderly operation of a school.
4. Bullying also includes retaliation against a student for asserting or alleging an act of bullying.
STALKING is defined by South Dakota Codified Law (22-19A-1.) as:
1. Willfully, maliciously, and repeatedly following another person
2. Making a credible threat to another person with the intent to place that person in reasonable fear of death or great bodily injury; or
3. Willfully, maliciously, and repeatedly harassing another person by means of any verbal, electronic, digital media, mechanical, telegraphic, or written communication.
CYBERBULLYING includes transmission of information over the internet or other forms of electronic communications on, computers, tablets, cell phones, or other devices, and will not be tolerated. This includes, but is not limited to, harassing, teasing, intimidating, threatening or terrorizing another person by sending or posting inappropriate and/or hurtful emails, text messages, pictures or images, website postings, blogs, or any form of social media. Pursuant to SDCL 13-32-18, neither the physical location nor the time of day of any incident involving the use of computers or other electronic devices is a defense to any disciplinary action taken by a school district for conduct determined to meet the definition of bullying in § 13-32-15.
NOTE: this is not limited to peers but can consist of staff to student as well.
We take bullying very seriously so please take your time to be as accurate and honest as possible.
*Reference Policy JGC and JGC-P
Email Address (OPTIONAL - Only needed if you desire a copy of this report)
Your Name and Role (OPTIONAL - but helpful for investigation)
For example: John Doe Parent
What school is this incident associated with?
East Middle School
North Middle School
South Middle School
Southwest Middle School
West Middle School
Central High School
Rapid City High School
Stevens High School
Victim's Name (optional, but needed for investigation)
Suspected Bully's Name(s)
Please list all suspected bullies associated with this incident.
Date of most recent alleged incident
List any potential witnesses
Please provide a detailed description of the incident.
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This form was created inside of State of South Dakota K-12 Data Center.