RTP Complaint Form 01-2025

Please complete this form to report a concern related to a service provided by RTP.
Type of Complaint (Check all that Apply)*

ADATitle VIOther
Rights you Believe were Violated (Check all that apply):*

RaceColorSexNational OriginAgeReligionLimited English ProficiencyOther
Name*
Date

MonthDayYear
Date
Mailing Address
Phone Number*
2. RTP Staff Involved:
3. What Happened:*
4. Witnesses or Others Aware
Date of Incident*

MonthDayYear
Date
*(Email any additional information to customerservice@rtprides.org)*

By signing below you are giving RTP permission to investigate this complaint. Also you affirm the information is true to the best of my knowledge.
Signature*

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Date

MonthDayYear
Date
Email Address*
example@example.com
Should be Empty: