Appendix A: Model complaint form
Guidance for governors on how to deal with complaints.
This file may not be fully accessible.
The person who experienced the problem should normally fill in this form. If you are making a complaint on behalf of someone else, please fill in Section B also. Please note that before taking forward the complaint we will need to be satisfied that you have the authority to act on behalf of the person concerned. If you are a pupil the school will help you complete this form, will explain it to you and will give you a copy of it when it is completed.
Your details
Surname
Forename(s)
Title: Mr/Mrs/Ms/other
Address and postcode
Daytime phone number
Mobile phone number
Email address
How would you prefer us to contact you?
If you are making a complaint on behalf of someone else, what are their details?
Their name in full
Address and postcode
What is your relationship to them?
Why are you making a complaint on their behalf?
About your complaint (continue your answers on separate sheets of paper if necessary)
Name of the school you are complaining about.
What do you think they did wrong or did not do?
Describe how you have been affected.
When did you first become aware of the problem?
If it is more than three months since you first became aware of the problem, please give the reason why you have not complained before.
What do you think should be done to put matters right?
Have you already put your complaint to a member of staff?
If so, please give brief details about how and when you did so.
Signature of complainant: Date:
Signature if you are making a complaint on behalf of someone else
Signature: Date:
Please send this form and any documents to support your complaint to:
[Insert name of complaint handler]
[Insert address and contact details of complaint handler]
Official Use
Date acknowledgement sent: By whom:
Complaint referred to: Date: