Home Administrative Complaint Administrative Complaint Form to Complete Identification du plaignant | Complainant Information Prénom | First name * Nom | Last name * Adresse | Adress Addresse | Adress * Ville | City * Province | Province * - Select - Alabama Alaska American Samoa Arizona Arkansas Armed Forces (Canada, Europe, Africa, or Middle East) Armed Forces Americas Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon - Select - Alabama Alaska American Samoa Arizona Arkansas Armed Forces (Canada, Europe, Africa, or Middle East) Armed Forces Americas Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Code postal | Postal Code * Courriel * Téléphone | Phone number * Numéro de membre VITA | Member VITA ID Statut | Status Candidat à la formation | Training Candidate Membre certifié | Certified Member Membre sauvetage sportif | Sport Lifesaving Member Membre Leadership | Leadership Member Bénévole | Volunteer Officiel | Official Personnel | Lifesaving Staff Member Autre... Motif de la plainte | Reason for Complaint Veuillez préciser la nature de la plainte | Please describe the nature of your complaint Décrivez la situation et le motif de la plainte : Veuillez préciser les démarches préalablement effectuées | Please describe any steps previously taken * Décrivez quelles étapes (contacts, courriels, appels, etc.) vous avez fait avant de compléter ce formulaire de plainte : Documentation | Supporting Documentation Téléverser un fichier Upload Merci de joindre à votre plainte vos pièces justificatives (documents, photos, rapport de situation d'échec, etc.)One file only.2 MB limit.Allowed types: jpg png txt pdf doc docx xlsx. Submit