ទម្រង់ព័ត៌មានរាយការណ៍អំពីករណីរំលោភបំពានកុមារ

1.Details of alleged victim (*required)


FemaleMale




2. Details of alleged perpetrator (*required)


FemaleMale



3. Details of concern, allegation or complaint (Include dates/times and location(s) the incident(s) occurred as well as witnesses, if known.)

4. Does the alleged victim know about the report?

YESNO

5. Can you provide any evidence?

YESNO

6.Details of the person completing the form (optional)