Complaint Form

Title:

First Name:

Surname:

Business Name:

Address:

Telephone:

Mobile:

Email:

Address:

If different to above Address

Summary of Complaint:

Please tell us clearly where we did not meet your expectations

Previous Contact:

Where possible, please provide names and times of discussions held with Town of Claremont staff

Details:

If any

Expectation:

Please detail how you would like your complaint resolved

Comments:

Please detail any other comments here

Do you want to be contacted about this?:

YesNo