Procedures for Reporting Allegations of Bullying Alice ISD The district prohibits bullying on school property, at school-sponsored or school-related activities, or in any vehicle operated by the district. Bullying may be verbal or written expression or expression through electronic means, or physical conduct. The district and any student or parent of a student who believes that the student or another student has experienced bullying or that a student has engaged in bullying is encouraged to immediately report the incident does not tolerate bullying. Retaliation against anyone involved in the complaint process is a violation of district policy and is prohibited. Students or parents may report an alleged incident of bullying, orally or in writing, to a teacher, counselor, principal or other district employee. The campus administrator will follow up on the submitted complaint and any other important matters pertaining to the complaint. We encourage you to communicate with your

designated campus administrator during this time. More information about the district’s bullying procedures/forms is found below and the bullying policy can be found at www.aliceisd.net.

ALICE ISD BULLYING PROCEDURES Texas Law Related to Bullying: Texas Education Code Chapter 25, Section 25.0342 (a); Student Code of Conduct: requires each independent school district in Texas to have a local policy that: (7) Prohibits bullying, harassment, and making hit lists and ensures that district employees enforce those prohibitions; and (8) Provides, as appropriate for students at each grade level, methods, including options, for: (a) managing students in the classroom and on school ground (b)disciplining students; and(c) preventing and intervening in student discipline problems, including bullying harassment and making hit list. (b-1) The methods adopted under Subsection (a)(8) must provide that a student who is enrolled in a special education program under Subchapter A, Chapter 29, may not be disciplined for conduct prohibited in accordance with Subsection (a)(7) until an admission, review, and dismissal committee meeting has been held to review the conduct. The requirements for prohibiting bullying, harassment, and making hit list are quite detailed and there is also a requirement in law to require the local school district policy to “ensure that district employees enforce those prohibitions.” Under the requirements of 37.001 (a) (8) the school district is also required to have specific options developed under local policy that are appropriate to each grade level that provide for preventing and intervening in student discipline problems, including bullying, harassment, and making hit list. Texas Education Code Chapter 25, Section 25.0342 also offers a parent an opportunity to transfer their child to another campus if their child has been determined by the school to have been bullied. It is important for each student to report any bullying or threats to the nearest teacher or adult at school as soon as possible so school officials may take appropriate action. If you have concerns about bullying meet with the campus principal to express your concerns. If your child is receiving special education services go to the ARD committee to focus on the problem and arrange a plan to intervene at the campus level. For additional guidance related to addressing your concerns, we encourage you to visit your district office for clarification. In addition, this procedure is intended to assist you in responding to a bullying, cyber bullying harassment, hazing, dating violence, sexting, and/or spoofing concern expressed by a student. The recommended steps are not all inclusive and other steps may be needed for the investigation and resolution. The goal of the investigation is to gather as much information as possible regarding the complaint so that a conclusion is made and a Safety Action Plan is determined. The Texas Education Code, Section 37.0832 (a) defines the following as: Bullying: means, subject to Subsection (b), engaging in written or verbal expression, expression through electronic means, or physical conduct that occurs on school property, at a school-sponsored or schoolrelated activity, or in a vehicle operated by the district and that: (1) has the effect or will have the effect of physically harming a student, damaging a student's property, or placing a student in reasonable fear of harm to the student's person or of damage to the student's property; or (2) is sufficiently severe, persistent, and pervasive enough that the action or threat creates an intimidating, threatening, or abusive educational environment for a student. (b) Conduct described by Subsection (a) is considered bullying if that conduct: Alice ISD Bullying Procedures

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(1) exploits an imbalance of power between the student perpetrator and the student victim through written or verbal expression or physical conduct; and (2) interferes with a student's education or substantially disrupts the operation of a school. (c) The board of trustees of each school district shall adopt a policy, including any necessary procedures, concerning bullying that: (1) prohibits the bullying of a student; (2) prohibits retaliation against any person, including a victim, a witness, or another person, who in good faith provides information concerning an incident of bullying; (3) establishes a procedure for providing notice of an incident of bullying to a parent or guardian of the victim and a parent or guardian of the bully within a reasonable amount of time after the incident; (4) establishes the actions a student should take to obtain assistance and intervention in response to bullying; (5) sets out the available counseling options for a student who is a victim of or a witness to bullying or who engages in bullying; (6) establishes procedures for reporting an incident of bullying, investigating a reported incident of bullying, and determining whether the reported incident of bullying occurred; (7) prohibits the imposition of a disciplinary measure on a student who, after an investigation, is found to be a victim of bullying, on the basis of that student's use of reasonable self-defense in response to the bullying; and (8) requires that discipline for bullying of a student with disabilities comply with applicable requirements under federal law, including the Individuals with Disabilities Education Act (20 U.S.C. Section 1400 et seq.). (d) The policy and any necessary procedures adopted under Subsection (c) must be included: (1) annually, in the student and employee school district handbooks; and (2) in the district improvement plan under Section 11.252. (e) The procedure for reporting bullying established under Subsection (c) must be posted on the district's Internet website to the extent practicable. Cyber-bullying: Cyber bullying involves the use of information and communication technologies to support deliberate, repeated, and hostile behavior by an individual or group, that is intended to harm others. "Cyber-bullying" is when a child, preteen or teen is tormented, threatened, harassed, humiliated, embarrassed or otherwise targeted by another child, preteen or teen using the Internet, interactive and digital technologies or mobile phones. It has to have a minor on both sides, or at least have been instigated by a minor against another minor. Once adults become involved, it is plain and simple cyber-harassment or cyber-stalking. Adult cyber-harassment or cyber-stalking is never called cyber-bullying. Alice ISD Bullying Procedures

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Harassment: means threatening to cause harm or bodily injury to another student, engaging in sexually intimidating conduct, causing physical damage to the property of another student, subjecting another student to physical confinement or restraint, or maliciously taking any action that substantially harms another student's physical or emotional health or safety. Section 37.001 Hit List: means a list of people targeted to be harmed, using: (A) a firearm, as defined by Section 46.01(3), Penal Code; (B) a knife, as defined by Section 46.01(7), Penal Code; or (C) any other object to be used with intent to cause bodily harm. Hazing: Any “intentional, knowing or reckless act, occurring on or off the campus of an educational institution, by one person alone or acting with others, directed against a student, that endangers the mental or physical health or safety of a student for the purpose of pledging , being initiated into, affiliation with, holding office in, or maintaining membership in an organization. “Activities such as branding, whipping, confinement, sleeping deprivation, and forced alcohol consumption can be considered methods of hazing, Section 37.151(6) Bullying, Cyber-bullying, Harassment, and Hazing of another student includes tormenting, threatening, taunting, stalking, intimidating, harassing, humiliation, and/or coercing through written, verbal, nonverbal and/or electronic communication that is severe, persistent, or pervasive such that is: a. b. c. d. e.

Affects the student’s ability to participate in or benefit from an educational program or activity, or otherwise adversely affects the student’s educational opportunities; and/or Creates an intimidating, threatening, hostile, or abusive educational environment; and/or Disrupts the educational process and/or endangers the general health, safety and welfare of the student; and/or Has the purpose or effect of substantially or unreasonably interfering with the student’s academic performance; and/or Otherwise adversely affects the student’s educational opportunities.

Dating violence: occurs when a person in a current or past dating relationship uses physical, sexual, verbal, or emotional abuse to harm, threaten, intimidate, or control the other person in the relationship. Dating violence also occurs when a person commits these acts against a person in a marriage or dating relationship with the individual who is or was once in a marriage or dating relationship with the person committing the offense. For purposes of this policy, dating violence is considered prohibited harassment if the conduct is so severe, persistent, or pervasive that the conduct: a. Affects a student’s ability to participate in or benefit from an educational program or activity, or creates an intimidating, Alice ISD Bullying Procedures

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threatening, hostile, or offensive educational environment; b. Has the purpose or effect of substantially or unreasonably interfering with the student’s academic performance; or c. Otherwise adversely affects the student’s educational opportunities. Sexting: under Texas Penal Code 43.26 it is a felony to knowingly or intentionally possess or promote material that visually depicts a child younger than 18 years of age at the time the image of the child was made who is engaging in sexual conduct. Texas Penal Code 43.261 is titled Electronic Transmission of Certain Visual Material Depicting Minor. A person who is a minor commits an offense if the person intentionally or knowingly: 1. By electronic means promotes to another minor visual material depicting a minor, including the actor, engaging in sexual conduct, if the actor produced the visual material or knows that another minor produced the visual material; or 2. Possesses in an electronic format visual material depicting another minor engaging in sexual conduct, if the actor produced the visual material or knows that another minor produced the visual material. Online Impersonation/”Spoofing”: Texas Penal Code 33.07 prohibits online impersonation and harassment. A violation under this statue occurs when a person, without the other person’s consent and with the intent to harm, defraud, intimidate, or threaten any person, uses the name or persona of another person to: 1. create a web page on a commercial social networking site or other internet website, or 2. post or send one or more messages on or through a commercial social networking site or other internet website

If a student’s report does not constitute any of the definitions stated above, a Student to Student Mediation is available.

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STEPS TO REPORTING INCIDENTS: 1. A student may report any form of bullying, cyber-bullying, harassment, and/or hazing by utilizing the available Student Incident/Complaint Report that is available through any counselor or administrator. Counselors and administrators may be asked to offer students assistance in filling out the form. In addition, the student (s) may complete the form in a secure location, such as an administrative office. The Student Incident/Complaint Report will be kept by the investigating administrator. 2. Administrators, counselors, teachers, paraprofessionals and any other staff members are to immediately report to the campus principal/administrator any comment, suggestion, and/or observation made by a student who bullies, cyber-bullies, harasses and/or hazes anyone on the campus. 3. The person making the report will describe exactly what occurred on Incident Report. 4. The campus principal/administrator/counselor will set up individual meetings with the victim and the alleged perpetrator(s) within 48 hours after allegation of bullying, cyber-bullying, harassment, and/or hazing is made. 5. The campus principal/administrator/counselor shall document specific dates of alleged incidents, specific dates of all steps taken, and names of all parties involved. 6. The campus principal/administrator/counselor shall contact the appropriate individuals. 7. If the allegation involves an employee, contact the school administrator for further guidance.

CONDUCTING AN INVESTIGATION The campus principal/administrator will set up separate individual meetings with the victim and alleged perpetrator(s) within 48 hours after the allegation of bullying, cyber-bullying, harassment, and/or hazing is made. In order to conduct an investigation, establish a conclusion based on information and develop a Safety Action Plan. A Stay Away Agreement will be also available. 1. The principal/counselor will individually question the victim and perpetrator(s) in a non-threatening manner for initial inquiry. 2. When questioning the victim and perpetrator(s) gather as many details as possible, such as: • • • • • •

When, where, and how the incident occurred; Exactly what the alleged perpetrator(s) said and how often; Names of possible witnesses; Has the victim informed parents and/or anyone else; Victim’s reaction to the incident; and, Are there other victims of the same alleged perpetrator(s)?

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3. Meet with parties involved separately so they can provide a statement of incident. a. If the victim and/or alleged perpetrator(s) are physically, mentally, or academically unable to write or type a statement, they can give a verbal statement and allow an adult to document it on paper. The principal/administrator can delegate a staff member to write or type the verbal statement. b. If the victim and/or alleged perpetrator(s) are unwilling to write or type a statement, the principal/administrator may write or type the statement from the information gathered. c. At the individual meetings, read the submitted statement back to the victim and alleged perpetrator separately to ensure the incident is completely understood and correct; review and determine if any clarifications or revisions are needed. Upon completion, the victim and alleged perpetrator(s) will each sign their individual statement. 4. Call the witnesses in and question them individually about the regarding incident(s). Have witnesses write or type a statement of incident; it must be signed and dated. Inform the witnesses to keep incident(s) confidential with the exception of their parents/guardians. A Witness Statement form will be available. 5. After a thorough review of the documentation collected, draw a conclusion and formulate a Safety Action Plan and use the plan to address the concerns with the victim and the alleged perpetrator. If found responsible, the perpetrator will write a letter of apology to the complainant explaining why their behavior was hurtful; the perpetrator will also have to attend an empathy counseling session. 6. Follow-up with the victim and his/her parents.

SAFETY ACTION PLAN A SAFETY ACTION PLAN, includes specific measures taken to increase the safety of the victim, and the welfare of any students(s); and should be drawn up immediately to prevent further harm. The Safety Action Plan should be developed with the victim’s input and may include, but will not be limited to, the following elements: DURING SCHOOL •

• •

If victim and alleged perpetrator(s) have one or more of the same classes and/or lunch period, measures need to be taken to separate them. This may include changing one or both of their schedules and/or a change of campus. If they are to remain in the same lunch period due to grade level lunches, the parties involved need to be seated as far away from each other as possible. Both the victim and alleged perpetrator’s walking routes to and from classes need to be mapped out (a school map can be utilized designating their new routes) and accommodations need to be

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•

•

•

made so they will not confront each other. Identify which restrooms each party can use to avoid confrontation. The maps with designated routes must be included and attached as part of the Stay Away Agreement; a copy must be issued given to the victim and alleged perpetrator(s). If behaviors have allegedly occurred in a particular area(s), such as victim’s locker or a specific restroom, the perpetrator must be informed to stay away from these locations. This will also be included in the Stay Away Agreement. If On Campus Suspension (OSS) is a consequence for both parties, they need to be kept away from each other in different rooms, or serve their time on different dates. If there is more than one alleged perpetrator, they should be separated or serve their time on different dates during On Campus Suspension to avoid further collaboration. Help the victim identify adults within the school setting, which he/she will feel comfortable enough with, in order to report persistent unwanted behavior.

BEFORE AND AFTER SCHOOL: • • •

• •

•

Both the victim and the alleged perpetrator’s walking routes to and from school need to be discussed and arranged so they will not confront each other during this time. Make sure parties involved wait in different areas before the first bell rings and after school. Inform teachers and staff members who deal with the parties involved; ask them to be alert and to notify an administrator immediately if they observe any occurrences relating to the allegations. Keep allegations confidential and not to discuss alleged incident with the parties involved. If the victim is being bullied, harassed, or is in possible danger on a school bus, the victim or alleged perpetrator(s) will need to be removed and transferred to a different bus. If the victim and alleged perpetrator(s) are on the same sports team or extracurricular activities the coach/sponsor needs to be made aware of the situation, and measures need to be taken in order to keep them apart. If any school events occurring, such as a band concert, dance, play or field trip, inquire if either party plans to attend. If the parties involved are both attending, then measures need to be taken to keep them apart.

OUTSIDE OF SCHOOL: •

The alleged perpetrator(s) needs to be notified that if he/she begins and/or continues to communicate in any way with the victim (such as sending or posting gossip and/or spreading rumors) intentionally trying to damage the victim’s reputation, then discipline measures will be taken in accordance with the district’s student code of conduct. The perpetrator(s) could also be held criminally liable for any further action(s) taken. These could be construed as continued harassment, bullying, cyber-bullying, and/or hazing of the victim.

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ACTION PLAN FOR CYBER-BULLYING: If the alleged perpetrator(s) cyber-bullies the victim to the extent of creating a hostile school environment and/or puts the victim in physical danger, Alice ISD will provide the following list of steps to the parent/guardian(s): 1. Keep a printed copy of any form of communication to and/or from the alleged perpetrator(s); such as but not limited to emails, text messages, website postings, and/or blog entries, etc. 2. Report any form of electronic communication directly to the campus administrator/principal and/or counselor for documentation purposes.

IN ADDITION, PROVIDE THE VICTIM WITH: A list of general safety tips to aid the victim, such as: 1) Never walk alone 2) Screen phone calls 3) Do not reply to text messaging 4) Turn off any social networks 5) Lock doors at home when alone, etc. Once the Safety Action Plan is complete and both parties have agreed, inform both the victim and the alleged perpetrator’s parents/guardians to the logistics of the Safety Action Plan. All forms and Documents used need to be included with the Safety Action Plan. SCHOOL BASED STAY AWAY AGREEMENT The Stay Away Agreement provides a list of conditions that must be followed by the alleged perpetrator while on school grounds and/or at school-sponsored activities to ensure the safety of the victim. The Stay Away Agreement may be used in a conference with the alleged perpetrator and his/her parent or legal guardian. Every effort needs to be made to contact the parent/guardian; however, if the parent/legal guardian is unavailable or unwilling to attend the conference, the school may note this on the agreement and complete the form without parent/guardian consent. After Stay Away Agreement is signed, inform teachers and staff members who deal with the parties involved. Ask them to be alert and to notify an administrator immediately if they observe any occurrences relating to the allegations. Keep information confidential and do not discuss alleged incident with the parties involved.

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PROTECTIVE ORDERS/COURT ORDERED AGREEMENTS: Secondary Education Enforcement of Protective Orders When a protective order has been issued by a court, school administrators shall take the following steps: 1. Hold separate meetings with the victim and the alleged perpetrator to: a. Review the protective order and ramifications; b. Clarify expectations; c. Identify schedule overlaps, i.e. arrival/dismissal times and wait areas, classes, lunch times, before and after school activities, locker, etc. Whenever possible, face-to-face contact between the victim and alleged perpetrator(s) should be avoided. If changes need to be made, attention may be given to the victim’s preference, the burden of change for any bus, classroom or other schedule changes should be on the alleged perpetrator, not the victim. 2. In meeting with the victim, the school should consider: a. Helping the victim identify adults within the school setting with whom he/she feels comfortable b. Developing a Safety Action Plan c. Informing the victim that they have the right to have a support person present during all stages of the investigation. 3. In meeting with the alleged perpetrator, the school should consider developing a plan that may include the following key points: a. Identification of key staff members to check in with daily/weekly or as needed; b. Any needed class or schedule changes; c. Changes in arrival/departure times to/from school; d. Changes in arrival/departure times to/from classes; e. Clear review of expectations and consequences for any violations; and/or, f. Follow-up meeting dates to review progress and to make any necessary adjustments

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Attachments:

Resources:

Student Incident/Complaint Report Safety Action Plan School-Based Stay Away Agreement Witness Statement Form Letter to Parents Self-Reflection Activity Sheet Bullying Behaviors Bulling Chart AISD Pledge to Stop Bullying reportabully.com

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Date: _________________

Bullying Prevention Letter to Parents

From the Classroom of: ___________________________________________________________ Dear Parents/Guardians:

Alice ISD will be implementing a district-wide bullying prevention program.

Soon your child’s class will be learning about bullying prevention. Students will learn how bullying happens, and will learn and practice skills that will help the student deal with bullying issues. The students will be focusing on: • • • • • • •

How bullying is different from other conflicts between students How to tell an adult when they need help How a child who is bullied might feel Ways of helping others deal with bullying How to treat others at school The school’s plans for dealing with bullying behavior Assertive responses and other ways to deal with bullying behavior at school.

Students will also complete anonymous surveys so the school can collect information about their experience with bullying.

You can support your child’s learning by: • Talking with your child about bullying and about what she/he is learning • Role playing and practicing the skills learned at school • Participating in the school’s parent activities about bullying prevention • Talking to the counselor or principal about questions or concerns you may have about bullying behavior.

We would be happy to hear from you. If you should have any questions, or concerns please contact your child’s school counselor. We appreciate your involvement in making Alice ISD a better learning environment for all our students. Thank You. Sincerely,

Alice ISD PLEDGE TO STOP BULLYING This contract will be a record of your commitment to reduce bullying in your school. Read each item carefully. Then choose whether you want to sign this pledge. If you decide that you want to help stop bullying, print your name on the line below and then sign the bottom of the sheet in the space provided. By doing so, you are making a promise to your peers and to your school community. We congratulate you for your brave and important decision! I,

wish to reduce bullying in my school. (Print name)

I agree to: 1. Do my best to treat ALL my peers with respect and dignity in person AND online. 2. Not isolate, threaten, or harm my peers, or hurtfully tease, exclude, insult, or mock them. 3. Try to prevent or discourage my peers from humiliating, threatening, isolating or harming others. 4. Try to assist any student who is being mistreated, for the simple reason that, it is wrong to be unkind to another human being. 5. If I am comfortable doing so, inform my parent/guardian, teacher, or school administrator when I learn about or see hurtful behavior.

_____________________________ Student Signature

________________________ Date Signed

Witness Statement Form This form must be completed by witnesses of the alleged bullying. One form must be completed by each witness. All statements that relate to the bullying incident should be attached to the Situation Report.

Name of Witness: ____________________________________________________________ Date:_________________________ Complainant Name: _________________________________________________________Incident Date: ________________ Name of Interviewer: _______________________________________________________ Title: _________________________ When and where did the incident occur? What happened? What was your response? Who were the other witnesses? List and attach, if possible, evidence of bullying (for example, photos, notes, letters, damaged property). I agree that all of the above information is true and accurate to the best of my knowledge. Signature of Witness: _____________________________________________________________ Date: _______________ Name of person receiving this form: ____________________________________________ Date: _______________

Alice Independent School District Student Incident/Complaint Report Instructions for Reporting Incidents of Bullying, Cyberbullying, Hazing, Sexual Harassment, Dating Violence, and/or Sexual Violence An administrator or counselor who receives a report of bullying, cyberbullying, harassment, hazing, sexual harassment, dating violence, and /or sexual violence will address the following issues with the student who was the victim of the reported behaviors in a private meeting before assisting the student in completing the Student Complaint Form. RIGHT TO FILE AISD board polices prohibit bullying, cyberbullying, harassment, hazing sexual harassment, dating violence and sexual violence. All charges of this type of conduct will be taken very seriously by students, faculty, staff, administration and parents/guardians. AISD will make every reasonable effort to handle and respond to changes and complaints filed by students and employees in a fair, thorough, and just manner. Every reasonable effort will be made to protect the due process rights of all victims and all alleged perpetrators. INSTRUCTIONS Use this form to report bullying, cyberbullying, harassment, hazing, sexual harassment, dating violence and sexual violence so that school officials may investigate and take appropriate actions to increase your safety. Complete the form, providing as much detailed information as possible so that the complaint may be properly investigated. It is important that you report the facts as accurately and completely as possible and cooperate fully with the persons designated to investigate the complaint. WHERE TO FILE Complaint forms can be filed with any administrator or counselor. CONFIDENTIALITY To conduct this investigation in a confidential manner, the school will disclose the contents of your complaint only to those persons who have a need to know of your complaint. In signing the complaint form, you authorize the school to disclose the information you have provided regarding your complaint. Your complaint form will not be shown to alleged perpetrators(s). RETALIATION PROHIBITED Retaliation against a person who files a formal complaint is strictly prohibited and is grounds for disciplinary action, including but not limited to detention, suspension, cited (ticketed) by police officer, and expulsion.

Incident Report Complete the form, make a copy, and submit the original to the Principal’s office. Check one: _______Suspected bullying situation ______Confirmed bullying situation ______Conflict Date: ____________________ Signature of reporting adult: _________________________________ Name of complainant: _______________________________________ Grade: __________________ Name of accused: ___________________________________________ Grade: __________________ Are either of the above in a Special Program: _____________________________________________ Other witnesses/bystanders (if any): ___________________________________________________ __________________________________________________________________________________ Check and date all of the bullying behaviors that the complainant has experienced by the accused: Hurtful teasing

Stealing or damaging property

Spitting on him or her

Hurtful name-calling

Pushing

Hitting/Punching

Insulting remarks

Tripping

Slapping

Spreading lies/rumors

Grabbing

Slamming w/ shoulder

Socially rejecting

Pinching

Kicking

Sending nasty notes

Restraining

Threats

Eye rolling

Stalking

Other:

Check and date where the behaviors have occurred: Restroom

Hallway

Classroom

Cafeteria

Locker room

Gym

Library

Bus area

Parking lot

Outside (where?) Other:

Have you (the reporter) observed any mistreatment of this individual? ___________________________ Check and date the specific actions taken thus far to prevent and stop the behaviors? Conference w/ student

Loss of privileges

Restitution

Telephoned parent

Parent conference

Special assignment

Detention

Saturday school

ISS/Suspension

Other:

Approximately how long have the situations been occurring: ___________________________________ Parent contacted by: ________________________________Date: ______________Time:____________

ALICE INDEPENDENT SCHOOL DISTRICT SAFETY ACTION PLAN FOR STUDENTS The victim’s safety is top priority for any bullying, cyber bullying, harassment, hazing, dating violence and/or any situation where students are in any kind of harm or danger. It is a plan that includes specific measures taken to increase the safety of the victim and the welfare of any student(s). In addition, it may include a reassignment of a student to a different classroom or school-based alternative placement. If the alleged perpetrator(s) is found guilty, the Bullying Procedures in the Student Code of Conduct will be enforced; removal from events, extracurricular activities, bus transportation, UIL, etc. should be considered. The Safety Action Plan should be developed with the victim’s input and may include, but not limited to, the elements listed. Check all the actions that have been implemented and add any others that may be utilized. CLASSROOM REASSIGNMENT AND TRANSFER: o Victim and victim’s parent/guardian were given the option to transfer to another classroom on ___________________________________________________. o Victim will utilize the classroom reassignment option and will transfer to ______________________________________ class on ______________ (date). DURING SCHOOL: o Victim and alleged perpetrator(s) schedules have been reviewed and changes have been made to avoid confrontation and retaliation in the same classes (not applicable in all schools). o Victim and alleged perpetrator(s) lunch periods have been reviewed and changes have been made to avoid confrontation and retaliation during lunch (not applicable in all schools). o Victim and alleged perpetrator(s) have the same lunch period; however, arrangements have been made to seat all parties involved away from each other (delegate seating assignments). o Both the victim and alleged perpetrator(s) walking routes to and from classes have been mapped out (a school map with a drawing of delegated routes has been established) and accommodations have been made to avoid confrontation.

In addition, restrooms each party can utilize have also been identified to avoid confrontation. The school map with identified and specific routes will need to be included and attached as part of the Stay Away Agreement. o The perpetrator(s) has been informed to stay away from victim’s identified areas, such as a locker, extra-curricular or after school activities. This should also include the Stay Away Agreement form. o In School Suspension (ISS) has been given to one or both parties and arrangements have been made for them to serve their time on different dates or different places to avoid confrontation and retaliation. o There was more than one alleged perpetrator who collaborated in the behavior and arrangements have been made for them to serve their time on different dates from victim to avoid retaliation and from the other perpetrator(s) to avoid future collaboration. o Victim has identified adults within the school setting that he/she feels comfortable reporting persistent unwanted behavior or retaliation.

BEFORE AND AFTER SCHOOL: o Teachers and staff members who deal with the parties involved have been informed and asked to be alert and notify administration immediately if they observe any occurrences relating to the allegations. They were also reminded to keep the information confidential. o Parties involved have been given different areas to wait before the first bell and after school. o If the victim is being bullied, harassed, or is in possible danger on a school bus, then measures have been taken to remove the victim or alleged perpetrator(s) from that bus. o If the victim and alleged perpetrator(s) are on the same sports team or extracurricular activities, then the coach or sponsor needs to be made aware of situation. o Participation of any school events, such as band concerts, dance, or field trip has been discussed. If the parties involved plan to attend, then measures need to be taken to separate them. OUTSIDE OF SCHOOL: o The alleged perpetrator(s) has been notified that if he/she begins and/or continues to communicate in any way with the victim to the extent of substantially interfering with the school environment and/or orderly operation of the school, such as, sending or posting gossip and/or rumors as a means of damaging the victim’s reputation, then the discipline measures will be taken in accordance with

district policy. The perpetrator(s) could also be held criminally liable for any further action(s) taken. o If the alleged perpetrator(s) cyber bullies the victim to the extent of creating a hostile school environment and/or puts the victim in perceived physical danger, the school will provide the following steps to the parent/guardian: 1. Keep a printed copy of any form of communication to and/or from the alleged perpetrator(s), such as, email, text messages, website postings, or blog entries. 2. Report any form of electronic communication directly to the campus administrator or counselor for documentation purposes. 3. The campus principal or counselor will complete and submit the form to the Technology Department if the cyberbullying is happening through district servers/computers. 4. Continue to monitor computer use by placing any computer in a common area of the home, such as living room, for the duration of the investigation. 5. Make use of the district digital citizenship site by reviewing videos, lessons, cyber safety tips, and additional activities. IN ADDITION, PROVIDE THE VICTIM WITH: A list of general safety tips to avoid the victim, such as: *never walk alone *screen phone calls *do not reply to text messages *deactivate their Facebook or MySpace

Once Safety Action Plan is complete and both parties have agreed, inform both the victim’s and the alleged perpetrator’s parents/guardians of the logistics of the Safety Action Plan. All forms and documents utilized need to be included with the Safety Action Plan.

ALICE ISD SCHOOL-BASED STAY-AWAY AGREEMENT

The intent of this agreement is to increase safety for students who have been the victim of bullying, cyber bullying, harassment, hazing, sexual harassment, dating violence, or sexual violence. It is to be administered in a conference with the alleged perpetrator and his or her parent/guardian. Student:_________________________________________ Grade:_____________________ ID#_____________ Date(s) of Incident(s): ____________________________________________________________________________

Description of behaviors involved in incident: _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________ Date of conclusion:

Date of Parent/Guardian notification:

In order to protect the rights and safety of all member of our school community, you are required to stay away from _____________________________________________ at all times or do not attempt to communicate in any way or form. This means that you may not approach, talk to or about, sit by, send information to or have any contact with: ________________________________________ at school, a school-related activity or event on or off school property, school buses, and bus stops. In addition, you may not get a friend, relative, or anyone to contact the above named student in any way. In addition, the following actions are effective immediately: Arrival Information: Time: Entrance: Wait area before school: Departure Information: Time: Exit: Wait area after school:

Bus/Parking Information:________________________________________________________________ Current Schedule 1 2 3 4 5 6 7 8

New Schedule 1 2 3 4 5 6 7 8

Other Schedule Information:________________________________________________________________________

Extracurricular Activities:___________________________________________________________________________ _________________________________________________________________________________________________________ Other disciplinary actions:__________________________________________________________________________ ________________________________________________________________________________________________________ Violations of this agreement and acts of retaliation directly or indirectly toward _________________________________________________________will be taken seriously and will result in further disciplinary actions.

Your compliance will be monitored by (name staff title):_____________________________________ ________________________________________________________________________________________________________.

Dates Agreement is valid from:______________________________ to: ___________________________________ This agreement will be reviewed on: _____________________________________________________________ Signatures: Students:_________________________________________________________ Date:_____________________________ Parent/Guardian:_______________________________________________ Date:_____________________________ Administrator:__________________________________________________ Date:_____________________________ Counselor:_______________________________________________________ Date:_____________________________ cc: Principal *Assistant Principal *Counselor *Applicable School Personnel