Anonymous Reporting Form

This form is to be used for anonymous submission of complaints or concerns working at the Township of Puslinch.

Please note that because this is anonymous there will not be follow-up discussing the outcomes of your submission. If you choose to identify yourself the Human Resource Generalist may follow-up as needed.

Applicant Information

Do you want to submit this form anonymously? *

• Yes
• No

Name *

First

Last

Email Address *

A copy of this form will be sent the email address provided above.

Please provide details of the incident you are reporting. *

When did the incident occur? *

Date

Time

Who was involved in the incident? *

Is there any additional information we should know? *

Comment

Submit