Name:
Address:
Postcode:
Daytime telephone number:
Evening telephone number:
If applicable, name of child(ren) and year at school:
Your relationship to the school, e.g. parent, carer, neighbour, member of the public, student:
Please give details of your complaint:
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What action, if any, have you already taken to try and resolve your complaint? Who did you speak to, when, and what was the response?
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What actions do you feel might resolve the problem at this stage?
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Signature:
Date:
Official use
Date of acknowledgement:
By whom:
Complaint referred to:
Date: