Report a Concern
Use this form to report incidents or concerns in the Rock Island-Milan School District. Users may report anonymously by choosing to not fill in their name, address or phone. All other fields are required.
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Your first name
Your last name
Your street address
Your city
Your state
Your zip code
Your phone number
Date of incident/concern *
Location of incident *
If "Other," please specify
Subject of concern *
Your detailed description of what took place *
Your objection to this incident *
Have you reported this incident to a building administrator *
If yes, please identify the administrator. Give name, title, and date contacted
What do you request the district to consider as a possible solution? *
Acknowledgment *
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This form was created inside of Rock Island-Milan School District #41.