EmailMeForm
Accident and Near Miss Reporting Form
This form is to report any accidents that occur during your club or society activities. You can also report any near misses that occur which you'd like to highlight to student activities for future caution
If you require more space of people involved please email student.activities@brunel.ac.uk with the relevant details
Name
*
First
Last
Student Number
*
Club/Society Name
*
Email
*
Contact Number
*
Description of Accident or Near Miss
*
Please provide the details of all involved
Full Name
Student Number
Contact Number
Person One
Person Two
Person Three
Person Four
Person Five
