SEXUAL ABUSE COMPLAINT FORM CATHOLIC ARCHDIOCESE OF KADUNA

FULL NAME

Start with surname please

ADDRESS

DATE OF BIRTH

PHONE NUMBER

Gender

Male

Female

NAME AND ADDRESS OF PARENT/GUIDIAN

(If you are still a minor)

FULL NAME OF THE PERSON YOU ARE COMPLAINING ABOUT

PLACE WHERE THE CONDUCT OCCURED

WHEN DID IT HAPPEN?

DESCRIPTION OF YOUR COMPLAIN

HAS THIS BEING REPORTED BEFORE

Yes

If yes when, how, and to whom?

When was the last report

Who reported it?

Has the accussed being confronted or informed about your complain

Yes

If yes when and by who?

CAPTCHA

Math question (5 + 5 =)

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.

just to confirm you are human

Search