Suspected Bullying/Incident Reporting Form
Wallingford Public Schools
Parents/guardians, students and faculty can follow the processes below for reporting suspected Bullying.
BOE Policy 5131.911 Bullying
Suspected Bullying Reports
Parents/guardians, students or faculty can complete the attached form and return to the building administrator. Please download or make a copy from the link below. It is prefillable, you can populate and print, or print and write. If you wish for it to remain anonymous, simply put the completed form in a sealed envelope and address it to the building administrator. There is no need to write your name.
Suspected Bullying Report Form
Following claims, administration follows the steps outlined in our BOE Regulation on Bullying.
A summary of those steps includes; notifying the safe school climate specialist (usually the building admin.) no later than one day after a claim is reported, a written report is requested from students and staff within two days and administration may request written report from parents/guardians who orally report a suspected claim. The safe school climate specialist promptly reviews any claims, including anonymous reports and investigates or supervises the investigation after receipt of any written report. Parents/guardians of the alleged victim and offender are notified that such investigation has commenced.
If a verified act of bullying is determined then parents/guardians receive notification. Parents/guardians of the victim are invited for a meeting to discuss the safety of the student and the policies and procedures in place to prevent further acts of bullying. Parents/guardians of a student who commits a verified act of bullying are also invited to a meeting to discuss specific interventions undertaken by the school to prevent further acts of bullying. Parties involved receive interventions that may include education about offense, safety support plans, notification to law enforcement if necessary, discipline, counseling or a restorative meeting. There is a strong emphasis made to prohibit discrimination and retaliation against an individual who reports or assists in the investigation of an act of bullying.
Wallingford BOE Policy Definition of Bullying:
"Bullying" means an act that is direct or indirect and severe, persistent or pervasive which:
A. causes physical or emotional harm to a student;
B. places such student in reasonable fear of physical or emotional harm, or;
C. infringes on the rights and opportunities of an individual at school
“Bullying” shall include, but need not be limited to, a written, oral or electronic communication or physical act or gesture based on any actual or perceived differentiating characteristic, such as race, color, religion, ancestry, national origin, gender, sexual orientation, gender identity or expression, socioeconomic status, academic status, physical appearance, or mental, physical, developmental or sensory disability, or by association with an individual or group who has or is perceived to have one or more of such characteristics.
For purposes of this policy, “Cyberbullying” means any act of bullying through the use of the Internet, interactive and digital technologies, cellular mobile telephone or other mobile electronic devices or any electronic communications.
For purposes of this policy, “Teen Dating Violence” means any act of physical, emotional or sexual abuse, including stalking, harassing and threatening, that occurs between two students who are currently in or who have recently been in a dating relationship. Consistent with the requirements under state law, the Board authorizes the Superintendent or designee(s), along with the Safe School Climate Coordinator, to be responsible for developing and implementing a Safe School Climate Plan in furtherance of this policy. As provided by state law, such Safe School Climate Plan shall include, but not be limited to provisions which:
(1) enable students to anonymously report acts of bullying to school employees and require students and the parents or guardians of students to be notified at the beginning of each school year of the process by which students may make such reports;
(2) enable the parents or guardians of students to file written reports of suspected bullying;
(3) require school employees who witness acts of bullying or receive reports of bullying to orally notify the safe school climate specialist, or another school administrator if the safe school climate specialist is unavailable, not later than one school day after such school employee witnesses or receives a report of bullying, and to file a written report not later than two school days after making such oral report;
(4) require the safe school climate specialist to investigate or supervise the investigation of all reports of bullying and ensure that such investigation is completed promptly after receipt of any written reports made under this section and that the parents or guardians of the student alleged to have committed an act or acts of bullying and the parents or guardians of the student against whom such alleged act or acts were directed receive prompt notice that such investigation has commenced;
(5) require the safe school climate specialist to review any anonymous reports, except that no disciplinary action shall be taken solely on the basis of an anonymous report;
(6) include a prevention and intervention strategy for school employees to deal with bullying and teen dating violence;
(7) provide for the inclusion of language in student codes of conduct concerning bullying;
(8) require each school to notify the parents or guardians of students who commit any verified acts of bullying and the parents or guardians of students against whom such acts were directed not later than forty-eight hours after the completion of the investigation described in subdivision (4), above (A) of the results of such investigation, and (B) verbally or by electronic mail, if such parents’ or guardians’ electronic mail addresses are known, that such parents or guardians may refer to the plain language explanation of the rights and remedies available under Conn. Gen. Stat. Section 10-4a and 10-4b published on the Internet website of the Board;
(9) require each school to invite the parents or guardians of a student against whom such act was directed to a meeting to communicate to such parents or guardians the measures being taken by the school to ensure the safety of the student against whom such act was directed and policies and procedures in place to prevent further acts of bullying;
(10) require each school to invite the parents or guardians of a student who commits any verified act of bullying to a meeting, separate and distinct from the meeting required in subdivision (9) above, to discuss specific interventions undertaken by the school to prevent further acts of bullying;
(11) establish a procedure for each school to document and maintain records relating to reports and investigations of bullying in such school and to maintain a list of the number of verified acts of bullying in such school and make such list available for public inspection, and annually report such number to the Department of Education and in such manner as prescribed by the Commissioner of Education;
(12) direct the development of case-by-case interventions for addressing repeated incidents of bullying against a single individual or recurrently perpetrated bullying incidents by the same individual that may include both counseling and discipline;
(13) prohibit discrimination and retaliation against an individual who reports or assists in the investigation of an act of bullying;
(14) direct the development of student safety support plans for students against whom an act of bullying was directed that address safety measures the school will take to protect such students against further acts of bullying;
(15) require the principal of a school, or the principal's designee, to notify the appropriate local law enforcement agency when such principal, or the principal's designee, believes that any acts of bullying constitute criminal conduct;
(16) prohibit bullying (A) on school grounds, at a school-sponsored or school-related activity, function or program whether on or off school grounds, at a school bus stop, on a school bus or other vehicle owned, leased or used by a local or regional board of education, or through the use of an electronic device or an electronic mobile device owned, leased or used by the Board, and (B) outside of the school setting if such bullying (i) creates a hostile environment at school for the student against whom such bullying was directed, or (ii) infringes on the rights of the student against whom such bullying was directed at school, or (iii) substantially disrupts the education process or the orderly operation of a school;
(17) require, at the beginning of each school year, each school to provide all school employees with a written or electronic copy of the school district's safe school climate plan; and
(18) require that all school employees annually complete the training described in Conn. Gen. Stat. §§ 10-220a or 10-222j related to the identification, prevention and response to bullying.
The notification required pursuant to subdivision (8) (above) and the invitation required pursuant to subdivisions (9) and (10) (above) shall include a description of the response of school employees to such acts and any consequences that may result from the commission of further acts of bullying. Any information provided under this policy or accompanying Safe School Climate Plan shall be provided in accordance with the confidentiality restrictions imposed under the Family Educational Rights Privacy Act ("FERPA") and the district's Confidentiality and Access to Student Information policy and regulations.
The Board shall submit its Safe School Climate Plan to the State Department of Education for review and approval. Not later than thirty (30) calendar days after approval by the Department, the Board shall make such plan available on the Board's and each individual school in the school district's web site and ensure that the Safe School Climate Plan is included in the school district's publication of the rules, procedures and standards of conduct for schools and in all student handbooks.
As required by state law, the Board, after consultation with the Connecticut Department of Education and the Connecticut Social and Emotional Learning and School Climate Advisory Collaborative, shall provide on the Board’s website training materials to school administrators regarding the prevention of and intervention in discrimination against and targeted harassment of students based on such students’ (1) actual or perceived differentiating characteristics, such as race, color, religion, ancestry, national origin, gender, sexual orientation, gender identity or expression, socioeconomic status, academic status, physical appearance or mental, physical, developmental or sensory disability, or (2) association with individuals or groups who have or are perceived to have one or more of such characteristics.
As required by state law, the Board shall post on its website the plain language explanation of rights and remedies under Connecticut General Statutes §§ 10-4a and 10-4b, as developed and provided to the Board by the Connecticut Social and Emotional Learning and School Climate Advisory Collaborative.
Public Act 19-166
Public Act 21-95
Conn. Gen. Stat. § 10-145a
Conn. Gen. Stat. § 10-145o
Conn. Gen. Stat. § 10-220a
Conn. Gen. Stat. § 10-222d
Conn. Gen. Stat. § 10-222g
Conn. Gen. Stat. § 10-222h
Conn. Gen. Stat. § 10-222j
Conn. Gen. Stat. § 10-222k
Conn. Gen. Stat. § 10-222l
Conn. Gen. Stat. § 10-222q
Conn. Gen. Stat. § 10-222r
Conn. Gen. Stat. §§ 10-233a through 10-233f
Policy Adopted: 01/21/03
Policy Revised: 08/21/06, 07/21/0/, 12/12/11, 3/28/22