Commendation/Complaint/Comment Form

2. Your First Name*

3. Your Last Name*

4. Phone Number*

   xxx-xxx-xxxx

6. Your email*

8. Address1

10. Address2

12. City

13. State

14. Zip

16. I would like to..*
    -- Select One --Commend a Police employeeComplain about a Police employeeComment about Police services

18. Employee Name*

    If you do not know the name enter "unknown" or if your incident does not involve a specific employee enter "N/A"

19. Employee Name (2)

20. Employee Name (3)

21. Employee Name (4)

23. Case or Call Number if known

24. Location of Event

26. Approximate Time of the Event*

27. AM / PM

    1. AM
    2. PM

28. Date of the Event*

30. Additional information about the event*

Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

* indicates a required field