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 according / code indicated by the first six boxes, which must with parental –Perpetrator be ticked or initialled when each action is group home pupils Authority arranged initiated: involved taken. Additional forms of action indicated yr dealt be / with sent should be taken if appropriate. work Governors parents, Local disciplinary to teacher be discussion on class to to to counselled Agencies informed / involved further to class school Discussion Head Other Victim Report Report Child Pupil Police Formal and Letters Follow to school Indiiv interview 1.Verbal abuse 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. Other 3.Violence a. Jostling b. Intimidation c. Punching/kicking d. Serious fighting e. Use of weapons, dangerous substances f. Other 4.Abuse of personal property 5.Graffiti 6.Incitement against black or minority people 7.Offensive literature or objects 8.
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 –Perpetrator and class 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 Other Agencies involved 1.Verbal abuse 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. Other 3.Violence a. Jostling b. Intimidation c. Punching/kicking d. Serious fighting e. Use of weapons, dangerous substances f. Other 4.Abuse of personal property 5.Graffiti 6.Incitement against black or minority people 7.Offensive literature or objects 8.
racist_incident_formf012.docx