Ipswich Basketball - Formal Complaint
Complaints MUST be lodged within 48 hours of the incident occurring.
Name
First Name
Last Name
Lodged by
Mobile number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Your team name
Club you are associated with
Complaint relates to
Date of incident
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Time of incident
Hour Minutes
AM
PM
AM/PM Option
Team A Name
Team B Name
Court Number:
Age group and division i.e. U16B Div 1
Referee name/s if known
What areas relate to your complaint
Please describe the reason for your complaint. Please ensure you use as much detail as possible
State the name of the Association official who first dealt with your complaint
Has the actions of your complaint occurred before
How did the situation make you feel
Do you believe that the actions of the person(s) involved were unlawful, unfair, unjustified, or a breach of the Basketball Australia Member Protection Policy? If so, why:
How do you feel this situation could be rectified?
Would you like a formal response?
Signature
Submit
Should be Empty: