Grievance Submission Form - Perimeter Forest

Name, Title or Grievor:(Required)

Enter Full Name and Title

Organization:(Required)

Enter Full Organization Name

Phone:

Email:(Required)

example@example.com

Date Grievance Submitted:

Name of Carbon Project or Company Grievance is against:(Required)

Please indicate the Interest Group(s) you most closely represent:(Required)

Economic Interests

Social Interests

Environmental Interests

Forest Agencies

Research Institutes and Universities

Other

If applicable, Indicate Other Interest Group(s):

Can we publish your Grievance (removing sensitive information such as name, and contact information):(Required)

Yes

Can we contact you to follow-up on your feedback:(Required)

Yes

Details of Event Leading to Grievance

Date, Time, and Location of Event:(Required)

Witnesses (if applicable):(Required)

Account of Event:(Required)

Provide a detailed account of the occurrence. Include the names of any additional persons involved.

Violations:(Required)

Provide list of any laws, policies, customs or guidelines you believe have been violated in the event described.

Proposed Solution:

Signature(Required)

As the grievor, your signature above indicates that the information you have provided on this form is truthful.

Date:(Required)

Date

Please retain a copy of this completed form for your records. If you submitted this form through the Perimeter Forest website, a copy of this form will be emailed to the address provided.

To ensure the most efficient handling of grievances, and effective responses to them, grievors are encouraged to be:

- Judicious – please be discerning in the amount of grievances made. For example, if you have similar grievances on multiple topics it is best to combine them.
- Constructive – please submit a grievance with the aim to reach resolution. For example, propose solutions to the impacts you are experiencing.

Phone

This field is for validation purposes and should be left unchanged.