Speak up safely Complaint, Concern, Incident, Review or Appeal Use this form to report a complaint or concern, record an incident, or request a review or appeal. Fields marked * are required. Immediate danger If someone is in immediate danger, contact the appropriate emergency, child-protection, medical or law-enforcement authority in your location before submitting this form. You do not need proof to report a concern. Please do not investigate, confront anyone, or place yourself or another person at risk. You may submit anonymously, although this may limit AFRDA’s ability to investigate or provide an outcome. 1 Nature of the matter Choose the submission type and subject that best fit your concern. Submission type * Select oneComplaintConcern or incident reportRequest for reviewAppeal Main subject * Select the main subjectProgramme or service quality, exclusion or failure to deliverCommunity meeting, field activity, training, research or demonstration siteSafeguarding, child protection or immediate safety concernHarassment, exploitation, abuse, intimidation or discriminationFraud, corruption, bribery, theft or misuse of funds or assetsProcurement, bidding, supplier treatment or collusion concernConflict of interest, gifts, favouritism or unethical conductPrivacy, personal data, photographs, stories or confidential recordsRecruitment, volunteering, internship or consultancy complaintEnvironmental or social harmUse of AFRDA's name, logo, communications or representationComplaint involving senior leadership or the normal complaints contactReview or appeal of a previous decisionOther or not sure Your selection securely directs the submission to the appropriate AFRDA contact. Related programme, service or department Select if applicableCommunity DiagnosticsCommunity Capacity BuildingDemonstration and LearningRestoration and ResilienceLivelihood DevelopmentPartnerships and PlanningEnvironmental SustainabilityClimate AdaptationCommunity DevelopmentAdvocacyVolunteer or internship opportunitiesEmployment, consultancy or procurementGovernance or administrationWebsite, media, photographs or communicationsNot sureOther Previous complaint, application or case reference 2 About you Provide contact details or choose to submit anonymously. Your relationship with AFRDA Select oneCommunity memberProgramme participant or beneficiaryParent, guardian or family memberCommunity leader or representativePartner organisationGovernment or public institutionDonor or funding partnerSupplier, bidder or contractorConsultant or technical expertVolunteer or internJob applicantAFRDA staff or former staff memberStudent or researcherMedia representativeWitnessMember of the publicOther Identity and confidentiality preference * Select how you would like your identity handled. I am providing my contact detailsI am providing my details but request restricted disclosure of my identityI am submitting anonymously You may leave your name, email address and telephone number blank when submitting anonymously. If you request a response, provide at least one safe way for AFRDA to contact you. Full name Organisation, institution, group or community Email address Telephone or WhatsApp number Country District, city or area Preferred contact method Select oneEmailTelephone callWhatsAppEither email or telephoneWritten responseNo response requiredI am submitting anonymously Safe time or instructions for contacting you 3 Details of the matter Share what happened or explain the decision you want reviewed. Subject or title * Complaint, concern, incident, review or appeal details * Programme, activity, event or project name Date of incident, activity, communication or decision Time, if known Country where the matter occurred District, city or area Community, project site, office, school, event or exact location People, organisations or AFRDA representatives involved Safety, protection or confidentiality concerns Select every option that applies. There is an immediate safety or protection concernA child or vulnerable person may be involvedMedical or specialist support may be requiredI am concerned about retaliationThe information is highly confidentialThere may be a personal-data or privacy risk When and how did you first become aware of the matter? Witnesses or other people who may have relevant information 4 Requested response and supporting information Tell AFRDA what outcome would be helpful and attach evidence if appropriate. Preferred response or outcome You may select more than one option. An explanation or written responseAn apologyCorrection or completion of a serviceImmediate safeguarding or protection actionConfidential investigationReview or reconsideration of a decisionProcurement or recruitment reviewPrivacy or personal-data actionRefund, repayment or financial correctionPolicy, training or system improvementReferral to an appropriate authority or specialistNo direct response; record the matter for learningOther Please explain your preferred response or outcome Supporting document Accepted formats: JPG, PNG, PDF, DOC, DOCX, XLS, XLSX and TXT. Maximum size: 10 MB. Do not upload material that could place someone at risk. 5 Review and submit Confirm your understanding before sending the report. I understand that AFRDA will use the information submitted to assess, direct and respond to this matter. Information may be shared with a limited number of authorised people where necessary for safety, legal compliance, specialist referral or a fair investigation. Please review the information and remove anything that is unnecessary or could place someone at risk.
