FORMAL COMPLAINT FORM
Complaint Lodged by:
*
First Name
Last Name
What is your position at TBI?
Please Select
Coach
Referee
Scorer
Parent
Spectator
Club Staff
What is your Phone Number?
-
Area Code
Phone Number
What is your Email?
*
example@example.com
What area is your complaint related to?
*
Please Select
Referee
Staff
Equipment
Another player / Opposition
Playing Environment
Other
Please describe what occurred
*
State when the problem arose
*
Rows
Day
Date
Time
Place
State the name of the person who first dealt with the problem
Rows
Name
Position
Has this problem occured before?
Yes
No
How did the incident make you feel?
Do you believe that the actions of the people invloved were unlawful, unfair, unjustified or a breach of the Basketball Queensland / Basketball Australia Member Protection Policy and, if so, why?
How do you feel this situation could be rectified?
Complaintants Signature
*
Date
*
-
Day
-
Month
Year
Date
Submit
Should be Empty: