Committee on Ministry

Kudos and Complaints

*Confidential*

Date ___________________

 Thank you so much for taking the opportunity to provide the Committee on Ministry with your feedback. An open community is a vibrant and healthy community!  We will review what you have shared with us, without the minister present, and we will then take the appropriate action.  You will be hearing back from the Chair of the COM.  Please note that while your signature and contact information are necessary for follow up by the Chairperson, this information will not be disclosed to committee members or the minister without your permission.

Please describe your compliment or concern, attaching additional sheets if necessary…

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Kudos to you for sharing your thoughts!

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Signature  _________________________________________________________________

Name                _______________________________________________________________________ 

Address  _______________________________________________________________________________

City, State, Zip  ______________________________________________________________________________

Home Phone  _______________________________ Work Phone ________________________________

Email address  ______________________________________________________