Safeguarding at YGAM
If the allegation is against a staff member, please contact the CEO prior to submitting the form.
Person Reporting
Name of Person Reporting
*
First Name
Last Name
Email of Person Reporting
*
example@example.com
Phone Number of Person Reporting
-
Area Code
Phone Number
Job Role of Person Reporting
*
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Incident
If any information is unknown for the mandatory fields, please type "N/A".
Date of Incident
*
/
Day
/
Month
Year
Date
Location of Incident
*
Organisation Name
*
Name(s) of Person(s) Concerned
*
If only first name is known this is fine.
Approximate Age
*
Putting child/adult or approx. age - E.g., Primary School / Year 7 is fine.
Description of Incident
*
Please put as many details as possible, exact terminology used where relevant, remembering what, where, when, and who.
Any Action Taken?
*
E.g., Reported to school DSL/ Police Called/ Delegate Removed from Meeting.
Any Other YGAM Staff/ Volunteers Present?
*
Names where applicable.
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