Grievance -

complaints

File A Grievance

This form is used to formally submit a grievance, complaint, or protest regarding the Madrona Neighborhood Association, or an individual(s) associated with the organization. We will only accept first-hand accounts of events or experiences that led to your reporting this grievance.

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Name (Leave blank if you'd like to be anonymous)

First

Last

Email (Leave blank if you'd like to be anonymous)

Date of Incident; if an incident occurred on more than one date, please submit the date of the first incident here.

Location(s) of grievance(s). Where did this take place? If this grievance is related to an electronic exchange through Email, text message, or other, please describe the communication type here.

Describe your grievance in detail. Please, mention specific dates and individual names if possible. Feel free to copy and paste electronic exchanges so we can read verbatim text.

How has this grievance affected you?

What is your recommendation to the Board of Directors for how to solve this grievance?

Would you like to be emailed back? (Please make sure you included an email above if so)

complaints

File A Grievance

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