First Name

Last Name

Email Address

Phone

What is the Best Way to Contact You? What is the Best Way to Contact You? Email Text Phone

What is the Best Time to Contact You? What is the Best Time to Contact You? Mon to Fri Sat to Sun Morning Afternoon Evening

What area within Parkland Community do you live in? What area within Parkland Community do you live in? Spruce Grove Stony Plain Parkland County

If you live within Parkland County, which rural area do you live in?

What is the nature of the grievance? Choose as many as applicable. What is the nature of the grievance? Choose as many as applicable. Animal Welfare Corporation Criminal Activities Environment Government Institution / Organization Human rights Media Other

If you choose 'other' above, please provide details:

Please describe your grievance in details. Who? What? Where? Why? When?

Please provide the name and contact information of any witnesses if applicable (optional)

Please list any policies, procedures, or guidelines that you believe have been disregarded in the grievance described above (optional)

What is your proposed solution?

File Upload (single file or ZIP package) File Upload (single file or ZIP package)

Additional Comments (optional)

Do you consent to having the above information stored on this website, as well as e-mailed to select Council officers or members for the purpose of its review, and potentially including it in an official grievance record, and to contact you if more information is required? Do you consent to having the above information stored on this website, as well as e-mailed to select Council officers or members for the purpose of its review, and potentially including it in an official grievance record, and to contact you if more information is required? Yes, I do consent.

Do you consent to having the above information stored on this website as well as e-mailed to select Council officers or members for the purpose of its review and potentially including it in an official grievance record, and of contacting you if more information is required? Do you consent to having the above information stored on this website as well as e-mailed to select Council officers or members for the purpose of its review and potentially including it in an official grievance record, and of contacting you if more information is required? Yes, I do consent.