Goodwill Central Texas Client Formal Complaint/Grievance Form

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1. Your Name

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2. Address, City & Zip Code (optional)

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3. Phone Number

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4. Email Address

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5. Would you like to be contacted by Goodwill staff regarding this complaint?

Yes

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6. Date of event related to the complaint/grievance

Date / Time

Date

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7. Location

Goodwill Community Center (Norwood & Clock Tower)

Goodwill Resource Center (Burleson Road)

Round Rock Job Help Center

San Marcos Job Help Center

Rosewood Job help Center

Georgetown Community Resource Center

Oak Hill Job Help Center

Other (please specify)

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8. Reason for Complaint

Age

Citizenship

Disability

Ethnicity

National Origin

Political Affiliation or Belief

Race

Religon

Gender

Other (please specify)

Goodwill Central Texas Client Formal Complaint/Grievance Form

Question Title

* 1. Your Name

Question Title

* 2. Address, City & Zip Code (optional)

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* 3. Phone Number

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* 4. Email Address

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* 5. Would you like to be contacted by Goodwill staff regarding this complaint?

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* 6. Date of event related to the complaint/grievance

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* 7. Location

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* 8. Reason for Complaint

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* 9. Please describe the event(s) that led you to file a complaint (Required.)

1. Your Name

2. Address, City & Zip Code (optional)

3. Phone Number

4. Email Address

5. Would you like to be contacted by Goodwill staff regarding this complaint?

6. Date of event related to the complaint/grievance

7. Location

8. Reason for Complaint

9. Please describe the event(s) that led you to file a complaint (Required.)