Grievance Submission Form
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Full Name
*
Enter your full name.
This field is required.
Email Address
*
Provide your email address for confirmation.
This field is required.
Phone Number
Optional: Enter your phone number for contact.
This field is required.
Grievance Type
*
Select the type of grievance from the list.
Select an option
Complaint
Suggestion
Feedback
This field is required.
Description of Grievance
*
Provide a detailed description of your grievance.
This field is required.
Submit
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