Feedback Form :: Piggs Peak Town Council | Official Website

1

Personal Details

First Name *

Last Name / Surname *

Email Address *

Phone Number *

Physical Address / Ward

Ward / Area

Ward 1 — Malandalahle and Bahloli Ward 2 — Mangwaneni Ward 3 — Town Centre Ward 4 — Nazarene Ward 5 — Mhlatane and Macambeni Ward 6 — Glen Township Other / Outside Municipality

2

Feedback Details

Subject / Title *

Detailed Feedback *

Location / Address of Issue (if applicable)

3

Service Satisfaction Rating

Services Used Recently (tick all that apply)

Roads & Transport Social Services Waste Collection Parks & Amenities Public Safety Council Administration

4

Contact Preference & Declaration

How should we follow up with you?

Email Phone Call SMS / Text No Follow-up Needed

Privacy Notice: Your personal information is collected in accordance with the municipality's Privacy Policy and will only be used to process your feedback. It will not be shared with third parties without your consent. You may remain anonymous by leaving personal details blank.

I confirm that the information provided in this form is accurate and true to the best of my knowledge.

5

Security Check

What is 8 + 3? *

Community Feedback & Service Review

Personal Details

Feedback Details

Service Satisfaction Rating

Contact Preference & Declaration

Security Check