Dignity Act Reporting Form

Dignity Act Reporting Form

Thousand Islands CSD - Dignity Act

The Dignity for All Students Act amends Education Law to put in place procedures for creation of a school environment free of discrimination and harassment. "The legislature finds 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..."

The District condemns and prohibits all forms of discrimination and harassment of students based on race, color, weight, national origin, ethnic group, religion, religious practice, disability, sexual orientation, gender, or sex by school employees or students on school property and at school sponsored activities and events that take place off school property. 

If you feel that a school employee or student has violated the protections assigned under the Dignity Act, please fill out the form below. All forms must contain all the information. Forms completed anonymously will be discarded. Contact information must be complete. 


2. *
Select at least 1.




6. *
Select at least 1.



9. *
Select at least 1 and no more than 1.









Yes No

13. If you had a previous issue with this individual, what was it?

14. m?

Yes No


16. *

17. *

By pressing "Submit" I am affirming under penalty of perjury, I understand that in a written instrument, any person who knowingly makes a false statement which such person does not believe to be true has committed a crime under section 210.45 of NYS Penal Law.


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