Adams - Cheshire Regional School District Bullying Incident Reporting Form
This form is to be confidentially maintained in accordance with the Family Educational Rights and Privacy Act, 20 U>S>C 1232g. Incident Report to be filled in the disciplinary record and incident entered into the electronic database.
Directions: Bullying is a series offense and will not be tolerated. If you are a student, the parent/guardian of a student, a volunteer or visitor, and wish to report an incident and alleged bullying, complete this form and return in to the Principal or Administrative Designee at the students school. All school employees are requires to report alleged violations. Contact the school for additional information or assistance at any time. This form can be completed anonymously by omitting signature and name and returning to the appropriate location. EVERY reported act of bullying will be investigated, and parents/guardians will be informed.
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