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Pupil Worries

Your Name *
Describe what happened / what is happening *
What date did this happen? *
Do you remember what time it happened?
Was this / is this? *
- Before School
- During School
- After School
- Unsure
Where did it happen? *
- In School
- Out of School
- Other
- Unsure
Can you give more detail about where (e.g. which corridor / where at home)?
Did anyone else see it? *
- Yes
- No
- Unsure
What are their names?
If physically hurt, please explain what happened:
Have you told anyone?
- Parent
- Brother / Sister
- Teacher
- Head of Year
- Other Family
- Other School Staff
- Other (please specify)
Have you told anyone (other):
Has this happened before?
- Yes
- No

Contact Us

Bourne Westfield Primary Academy
Westbourne Park
Bourne
Lincolnshire
PE10 9QS
Telephone: 01778 424152
Email:enquiries@bw.keystonemat.org

Bourne Westfield Primary Academy within Keystone Academy Trust

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