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Bully Reporting Form

Adrian’s mission is to “provide a safe, supportive environment that allows all students to learn.”

Adrian administration and staff strive to provide this to all students and protect student’s rights. Adrian takes a strict stance against bullying, harassment, and hazing (policies #413, 514, and 526).  If you see something, say something.  Please feel free to report possibily bullying, harassment, and hazing instances using the form below or contacting a district staff member or more specifically the building administrator.



Please complete this form to the best of your knowledge so we can assist you.
This information will be kept confidential with your campus administrator and/or superintendent.

Please Fill Out The Form Below

What type of bullying?
Where did the incident take place?

May we contact you for more information on this incident?

Thank you for reporting this incident. We appreciate your concern. When you click "Submit Form" this will be sent to the campus administrator.

Required Fields