Please print out form and mail or fax it to adress shown below this form.
For Social Justice
Have you been harassed or victimized by an
officer of the Calgary Police Service?
The Calgary Coalition for Social Justice is compiling accounts of harassment and misconduct by members of the Calgary Police Service. If you have been mistreated by the Police in any circumstance, including while in custody, please take time to fill out this questionnaire. These accounts will help all victims of police harrasment and violence, by holding the Service accountable, and determining how widespread the problem of police misconduct really is. Please return the filled out questionnaire to the Coalition. To work together with us, in our movement to stop police misconduct and gain social justice, or for further information, please contact us.Name: ___________________________________________________________
Address: _________________________________________________________
Phone: ___________________________________________________________
Date of the incident: _________________________________________________
Location of the incident: ______________________________________________
Name of the Officer(s) involved (if known): _______________________________
Please describe what happened: ________________________________________
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Do you know of any witnesses to the incident? _____________________________
Would they be willing to fill out a similar questionnaire? ______________________
Do you have any other evidence of the misconduct of the Calgary Police Service (photos, official record of complaints, etc.)? _______________________________
Did you suffer a loss of work or medical condition because of the incident? ________
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Do you wish to be contacted by the Coalition for Social Justice? _______________
THANK YOU VERY MUCH FOR FILLING THIS FORM OUT. THIS INFORMATION WILL BE USED TO TRY TO BRING JUSTICE TO VICTIMS OF POLICE MISCONDUCT AND PUSH FOR POLICE ACCOUNTABILITY.
Calgary Coalition For Social Justice
c/o Calgary & District Labour Council #307, 315 - 10th Ave. S.E., Calgary, Alberta T2G 0W2 Phone: (403) 262-2390 Fax: (403) 262-2408 E-mail: cdlc@telusplanet.netBack to home Media Coverage Correspondence