2. 
4. If this is an emergency, please call 9-1-1. If you need immediate assistance for non-emergent matters, please call 920-686-6500 and press option 2.
6. Would you like to remain anonymous? If so, you do not need to fill out the identifying information below. This information is only requested so we can make you aware of the outcome, or so that we can contact you in case we have questions.
8. First Name
9. Last Name
11. Phone Number (XXX-XXX-XXXX)
12. Email Address
13. Date of Birth: (MM/DD/YYYY)
15. Complaint Address or Location (Incident Location):
17. Description of Issue:
19. Would you like an Officer to follow up with you?
    -- Select One --Yes, pleaseNo, thank you
20. Upload Images/Attachments:
Leave This Blank:


22. 1. Receive an email copy of this form.
23. Email address

    This field is not part of the form submission.

24. Submit

* indicates a required field