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Contact(s)

Required fields are marked with asterisks (*)

Last Name

First Name

Address

Phone

Town/City

Postal Code

Please indicate how you would like us to contact you regarding your complaint?

Phone

Standard Mail

Details of Complaint (Please record information about what happened or what actions occurred)

Details of Complaint (Who was involved?)

Details of Complaint (Please provide dates and times)

Department or Service Involved

Location of Problem (if applicable)

Staff person(s) involved if known/applicable

How would you like to see your complaint resolved?

NOTICE OF COLLECTION

The personal information you choose to provide on this form is collected pursuant to the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA), M.56 R.S.O. 1990. The information you provide will be used to investigate the complaint and may be used for contact purposes. Questions about this collection can be directed to Director of Corporate Services/Clerk.

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