Violation Form

Event Title *
Village *
Commune *
District *
Province *
Start Date/time *
End Date/time *
Event Date Perpetrators Type of Acts & Size affected Victim
Violation type *
Event Description( Please describe what happened in as much detail as possible)
Upload Photo
jpg, png, gif, jpeg are only allowed types
Upload Supported Documents
pdf, docx, doc, xlsx are only allowed types
Reporting Date
Reporter Name
Reporter Contact

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