If you wish to make a commendation or submit a concern or suggestion concerning the actions of a Town of Christiansburg employee or about any aspect of Town operations, please complete this form.

You can also fill out a paper form in person at Christiansburg Town Hall, 100 E. Main St. and submit it to ATTN: Randy Wingfield, Assistant Town Manager, 100 E. Main St., Christiansburg, VA 24073

This form requires that you identify yourself and give specific details about the commendation/concern/suggestion. You will receive acknowledgement from the town manager that your submission was received. It is possible that you may be contacted and asked additional questions. Once the submission has been reviewed, the town manager will notify you of the resolution.

Section I- Employee Information

I would like to...*

Commend an employee

Submit a concern or suggestion

Employee Name:

Department (if known):

Section II- Citizen Information

Name:*

Street Address 1:*

Street Address 2:

City:*

State:*

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Zip Code:*

Telephone:*

Alternate Phone:

E-mail:

Preferred method of contact:*

U.S. Mail Telephone

Alternate Phone E-mail

Section III: Specific Details

When did this happen (date)?*

What time did this happen?:*

A.M./P.M.?

A.M.

P.M.

Where did this happen (location)?:*

Street Address 1:

Street Address 2:

City:

State:

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Zip Code:

What would you like us to know?:*

Section IV- Witness Information

Witness #1 (if applicable):

Name:

Street Adress 1:

Street Address 2:

City:

State:

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Zip Code:

Telephone:

Alternate Phone:

Relationship:

Witness #2 (if applicable):

Name:

Street Adress 1:

Street Adress 2:

City:

State:

Select a StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMassachusettsMarylandMichiganMinnesotaMississippiMissouriMontanaNorth CarolinaNorth DakotaNebraskaNevada New Hampshire New JerseyNew MexicoNew YorkOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVermontWashingtonWest VirginiaWisconsinWyomingWashington D.C.

Zip Code:

Telephone:

Alternate Phone:

Relationship:

By checking this box, I understand and acknowledge that any false, misleading, or untrue statements, accusations, or allegations made in relation to the employees of the Town of Christiansburg may lead to civil or criminal sanctions.*