Report an incident

Please answer all questions with as much information as possible – don’t worry if you are unsure what to write. If you need help to complete the form, please email welfare@cwa.ac.uk

All reports will be taken seriously, we will listen to you and will talk to you about how we can help and support you. All information shared with us is confidential and will only be shared with others on a need-to-know basis if you or others are at risk.

Are you completing this form:*

about yourselfbecause you are worried about someone else

Please choose

First name*

What is your first name?

Last name*

What is your last name?

Student number:

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What campus do you study at?*

What course are you in?

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How would you prefer us to contact you?

Email
Telephone

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What is the best days/times to contact you?

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Email address

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Telephone Number

Please write a valid telephone number

What happened?*

please fill the information

When did this happen? Please include dates and times if possible

Please include dates and times if possible

Where did this happen?*

In college
Outside of college
Online
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Do you know the assailant/perpetrator?*

Yes
No
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Please answer the question

Do they attend CWA?*

Yes
No
Prefer not to say
I do not know

Please answer the question

Name of assailant/perpetrator, if known:

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Thank you for completing this form. Your details will now be sent to the welfare team, who will contact you to talk about the information you have provided and how they can support you. In the meantime, if you need further support please contact the welfare team at welfare@cwa.ac.uk or on 01553 815265.

If you are in immediate danger or seriously injured call the emergency services on 999 immediately.

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Report an incident

Cambridge

Downham Market

King’s lynn

Sports Campus

Wisbech