Part 2 From School Date Name: Alleged Perpetrator ‘Victim’ Ethnic origin Gender Ethnic origin Gender Age: Age: School: School: The minimum course of action which wh should be taken with perpetrators is / indicated by the first six boxes, which must teacher with parental be ticked or initialled when each action is group pupils Authority home taken. Additional forms of action indicated arranged initiated: involved yr should be taken if appropriate. dealt school / be with and code sent work Governors Local parents, to to be discussion on to class to to counselled informed involved / Agencies further to Discussion Head Report Report Child Victim Pupil Police Formal according disciplinary Letters Follow school Indiiv interview 1.Verbal and threats a. Incidental b. Persistent, intended to be offensive c. Inciting others d. Vicious/threatening e. Other 2.Refusal to co-operate with others a. Sit next to/talk to/work with/help b. Persistent c. 3.Violence a. Jostling b. Intimidation c. Punching/kicking d. Serious fighting e. Use of weapons, dangerous substances f. Other of personal property 5.Graffiti 6. Incitement against black or minority people 7.Offensive literature or objects 8. OTHER
Part 2 From School Date ‘Victim’ Name: Alleged Perpetrator Ethnic origin Gender Ethnic origin Gender Age: Age: School: School: The minimum course of action which should be taken with perpetrators is indicated by the first six boxes, which must be ticked or initialled when each action is taken. Additional forms of action indicated should be taken if appropriate. Discussion with pupils Victim counselled Formal discussion and teacher Head involved Report to Local Authority Report to Governors Child further dealt with according to school disciplinary code Letters to parents, parental interview to be arranged Pupil to be sent home Police informed Follow on work initiated: Indiiv / class / yr group / wh school Agencies involved 1.Verbal and threats a. Incidental b. Persistent, intended to be offensive c. Inciting others d. Vicious/threatening e. Other 2.Refusal to co-operate with others a. Sit next to/talk to/work with/help b. Persistent c. 3.Violence a. Jostling b. Intimidation c. Punching/kicking d. Serious fighting e. Use of weapons, dangerous substances f. Other of personal property 5.Graffiti 6. Incitement against black or minority people 7.Offensive literature or objects 8. OTHER