Teacher Pastoral care form

Name(required)

Email(required)

Phone(required)

Date (YYYY-MM-DD)(required)

Whom do you have a concern with?(required)

A student A teacher A school staff member My parent My guardian Other (Please, specify)

If other then specify

Where did the incident happen?

What time did the incident Occur?

Was there any other person attending the incident as a witness?

Please provide the names of any person who attended the incidents and their designations

Please write a summary about the incident

How does the incident affect you negatively?

Would you like to mention anything else?

Preferred ways of communication

What is the best way you prefer to be contacted

Personal phone Email address Individual meeting with the care & support team member(s)

Please, choose the care & support team member whom you prefer to contact you

Ms. Suzan Khashan (Principal) Mr. Moustafa Abdelhakim (Vice principal) Ms. RehamBzour (Head of quality assurance)

Submit

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Student Pastoral care form

Name(required)

Email(required)

Phone(required)

Date (YYYY-MM-DD)(required)

Whom do you have a concern with?(required)

A student A teacher A school staff member A parent A guardian Other (Please, specify)

If other then specify

Kindly mention the type of incident

Verbal Bullying Relational Aggression Cyberbullying Sexual Bullying Prejudicial Bullying Other (Please, specify

If other then specify

Where did the incident happen?

What time did the incident Occur?

Was there any other person attending the incident as a witness?

Please provide the names of any person who attended the incidents and their designations

Please write a summary about the incident

How does the incident affect you negatively?

Would you like to mention anything else?

Preferred ways of communication

What is the best way you prefer to be contacted

Personal phone Parent's phone Personal email address Parent's email address Individual meeting with the care & support team member

Please, choose the care & support team member whom you prefer to contact you

Mr. Moustafa Abdelhakim (Vice Principal / Head of care & support team) Ms. Lana Nawiseh (Head of science /care & support team) Mr. Ahmad Ziad (Head of Islamic / care & support team) Ms. Alaa Al Rudainy (A support team member, Grades: 3 to 8) Ms. Dana Mohey (A support team member, Grades: 9 to 12)

Submit

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Important remarks

1. The information the student mentions is confidential.
2. The school principal and vice principal are the only persons who review the convers mentioned and then they proceed accordingly.