Feedback form

FEEDBACK FORM

We welcome your feedback and suggestions for any improvements to our service.

For further information or questions regarding this form, please contact Council via 9911 6555.

Surname *

First Name *

Address *

Postcode *

Phone (h):

Phone (w):

Phone (m): *

Email *

Reason for feedback *

ComplimentSuggestionRequest

Have you previously reported this to Council? *

YesNo

If the complaint is about a staff member or Councillor please send it to the General Manager marked confidential

Site address or location of incident: *

Details: *

Applicant Signature *

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Date signed *