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Parent / Student Concern
The following website may be of further use:
https://antibullying.nsw.gov.au/
The Relieving College Principal, Simon Warren, will receive an email informing him that you have submitted this form.
He will contact you directly to explain the next steps in the process.
All matters will be treated confidentially.
* Indicates required question
Email
*
Your email
1. Student Name:
*
Your answer
2. Name of your child:
(only parents/caregivers answer this question)
Your answer
3. Your best contact number:
Your answer
4. I would like to report a student for:
*
(select all which applies)
Peer Conflict = (a breakdown of a relationship, either verbal or physical)
Bullying = (repeated harassment, verbal, physical and/or social)
Cyberbullying = (online abuse)
Anti-social behaviour = (criminal and illegal activities)
Other:
Required
5. Date(s) of the incident:
*
Your answer
6. Location(s) of the incident:
*
Your answer
7. List the students involved:
*
(where applicable)
Your answer
8. List student witnesses:
(where applicable)
Your answer
9. Describe the nature of the incident:
*
Your answer
10. Any additional comments?
Is there anything else you think is worthy of a mention or requires further explanation or context?
Your answer
Send me a copy of my responses.
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