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Officer Conduct Form

2. Note
   Customer Service is a priority of the City of Portage. Your comments are appreciated. Remember to include your contact information to allow for a follow-up communication.

   Customer Service is a priority of the City of Portage. Your comments are appreciated. Remember to include your contact information to allow for a follow-up communication.

4. Name

5. Email Address

7. Address

9. City

10. State

11. Zip Code

13. Home Phone Number

14. Cell or Work Number

    Include an extension, if applicable.

16. Age

18. Type of Comment

    1. I Want to Commend...
    2. I Want to Suggest That...
    3. I Want to Complain About...

19. Badge Number(s) or Officer Name(s)

21. Date and Time of Incident or Occurence
    Date and Time of Incident or Occurence

    Date and Time of Incident or Occurence

23. Incident Address

25. City

26. State

27. Zip Code

29. What did he / she / they do?

Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

* indicates a required field