Incident Report - Alpha Delta Pi Foundation

Do not use this site to report events presenting an immediate safety or security threat. If this is an emergency, please call 911. After calling 911, contact Alpha Delta Pi volunteers as appropriate.

This report should be used to provide information to the International Organization regarding concerns of individual member/chapter behaviors or policy violations. Please fill out all applicable fields providing as much information as you are able. This will give Alpha Delta Pi the opportunity to offer the most effective and

appropriate support. Any attachments providing additional information or context should be submitted with this form.

Reports of hazing can also be reported to the Anti-Hazing Hotline at 888-668-4293 (888-NOT-HAZE). Callers may remain anonymous, or they can provide personal information so their concerns can be responded to directly.

Thank you for taking the time to report your concern. If you want to speak with a staff member about your concerns, please call our office at (404) 378-3164.

Confidentiality Statement

Alpha Delta Pi strives to keep the reporter’s identity confidential, whenever possible. For Alpha Delta Pi to address reported behaviors, we ask that the reporting party provide a name and at least a contact email as we are only able to address reports that are submitted from a verifiable source. Your information will remain confidential between parties, meaning the chapter and/or individuals will not know you as the reporting party. Additionally, as a reminder Alpha Delta Pi does not tolerate retaliation for reporting and will swiftly respond to any allegations. If you have concerns about how your information will be shared prior to reporting, please contact the Assistant Director of Accountability & Harm Reduction.

Family Statement

If you are a parent or family member of an Alpha Delta Pi collegiate member, please refer to the parent page to learn more about your involvement.

Your Name *

Phone Number

Email Address *

Your Relationship to Alpha Delta Pi

Chapter/University involved if member(s) involved are active collegians *

Member(s) Involved *

(Please use full names of involved parties when at all possible)

Alumnae Name, or Alumnae Association involved

Did this concern occur in an Alpha Delta Pi house/facility? *

Yes

No

Did this occur at an Alpha Delta Pi hosted or sponsored event? *

Yes

No

Date of Concern *

Time of Concern *

Type of Incident *

Were New Members (Alphas) present at the time of this incident?

Yes

No

Has the Vice President of Member Development been made aware of this incident?

Yes

No

Have you told any volunteers about this incident? This could include Chapter Advisors, Alumnae Association Officers, or International Officers.

Yes

No

Have you reached out to your college/university staff for guidance or support?

Yes

No

Please explain any steps that have been taken to date to address this incident. *

Describe the concern using specific and objective language (who, what, when, where, and how). Please include as many details as possible so Alpha Delta Pi can evaluate the information provided and determine appropriate next steps and response). Please also explain any steps that may have been taken to address this incident.

Upload Any Necessary Documents

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