Complaints form

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KITENGELA MUNICIPALITY COMPLAINTS LODGING FORM

Your Name

First

Last

Your Mobile Phone No.

Your Email

County

Sub County

Ward

2. HOW DID YOU GET TO KNOW ABOUT THE INSTITUTION COMPLAINTS HANDLING PROCESS?

3. PLEASE GIVE A BRIEF SUMMARY OF YOUR COMPLAIN/GRIEVANCE.

4. IS THIS THE FIRST INSTITUTION YOU ARE REPORTING THIS MATTER TO?

5. WHAT ACTION WOULD YOU WANT TO BE TAKEN?

6. HOW WOULD YOU LIKE TO RECEIVE FEEDBACK?

By affixing my name below, I confirm that the details shared are true to the best of my knowledge. (Input your name below)

Date of submission

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