WDRC Complaint Submission Form (Waterloo Minor Hockey)

WDRC Complaint Submission Form

Please complete this form to submit a complaint to the Waterloo Dispute Resolution Committee.

Date

Please enter today's date.

Date^*

Required

Complainant Information

Please provide all the information requested below

Name of Person making the Complaint (Complainant)^*

Required

Home Address^*

Required

Telephone (Day)^*

Required

Example: ###-###-####

Telephone (Evening)^*

Required

Example: ###-###-####

Email Address^*

Required

Example: [email protected]

Role of Complainant (please choose one)^*

Required

Respondent Information

Person Complaint being filed against (Respondent)^*

Required

Telephone (mobile)

Example: ###-###-####

Email Address

Example: [email protected]

Role of Respondent (please choose one)^*

Required

Nature of Complaint

What is the Nature of the Complaint^*

Required

Date of Incident(s)^*

Required

Please describe the complaint, identifying the facts and issues against the Respondent. Try to be brief in answering who what where and how you were treated differently from others (if at all?)^*

Required

Have attempts been made to resolve the complaint between the parties involved? Please specify Yes or No below.^*

Required

Resolution

What would you consider as a equitable resolution to this complaint?^*

Required

Email confirmation

Please fill in your email if you would like a confirmation of receipt of the Complaint submission

Email Confirmation of Submission

Example: [email protected]. Your submission will be sent to this address.

WDRC Complaint Submission Form (Waterloo Minor Hockey)

ALLIANCE HOCKEY Digital Network

Date

Complainant Information

Respondent Information

Nature of Complaint

Resolution

Email confirmation

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