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Complaints Registration Form
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* Indicates required question
Email
*
Your email
Date
*
MM
/
DD
/
YYYY
1. Complaint's Details/Optional
*
Choose
DR.
Mr.
Mrs
Ms
ID Number.
Your answer
Postal Addres
Your answer
Mobile.
*
Your answer
County
*
Choose
Wajir
Mandera
Garissa
Turkana
Marsabit
2. Which Institution or office are you complaining about ?
Ministry/Department/Agency/Company
*
Your answer
3. Have you Reported this matter to any other public institution/Public Official ?
*
Choose
Yes
No
4. If yes Which one ?
Your answer
5. Has this matter been the subject of court proceedings
Yes
No
Clear selection
6. Please give a brief summary of your complaint and attach all supporting documents[ [Note to indicate all the particulars of what happened , where it happened, when it happened and by whom]
*
Your answer
7. What action would you want to be taken ?
*
Your answer
8. How would you want the resolution to be given back to you ?
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Email
Phone
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