Safeguarding Report – Misean Cara

Safeguarding
Report form

Safeguarding policy

1. Do you wish to state your name? *

Name

Your contact phone number:

Your contact email address:

Preferred method of contact:

The best time and day for us to contact you:

2. In which country did the incident occur? *

3. Name of project: *

4. What is your relationship to Misean Cara: *

5. How did you become aware of this incident? e.g., witnessed it, was told by someone. *

6. Please identify the alleged perpetrator(s) if possible:

First

Last

7. Have you reported your concern to project personnel e.g. Project Manager, Safeguarding Officer, Designated Liaison Person or anyone else? *

If yes, who did you tell and what action did they take?

8. Where did this incident occur, e.g. at the project site? *

9. Please provide the specific or approximate time when this incident occurred, or you became aware of it: *

10. How long do you think it has been going on? *

11. Please provide all details regarding the alleged incident, including the locations of witnesses and any other information that could be valuable in assessing and resolving your report. *

Safeguarding Report form

Safeguarding
Report form