Errors were detected on the form contents
Last name *: This field is mandatory.
Given name *: This field is mandatory.
Address *: This field is mandatory.
Zip code *: This field is mandatory.
Postal office *: This field is mandatory.
Who do you think did something wrong? Who treated you badly? * (For example, a social worker or a teacher) *: This field is mandatory.
What happened? *: This field is mandatory.
Where did it happen? *: This field is mandatory.
When did it happen? *: This field is mandatory.
What else would you like to tell us about it?: This field is mandatory.
Has the issue been resolved already? *: This field is mandatory.
May we tell your parents about it?: This field is mandatory.