WHISTLEBLOWER REPORT FORM

Please provide the following details for any suspected serious misconduct or any breach or suspected breach of law or regulation that may adversely impact Achēv. Please note that you may be called upon to assist in the investigation if required.

Note: Please follow the guidelines as laid out in the Whistleblowing PolicyYou should share your question(s), concern(s), suggestion(s) or complaint(s) with someone who can address them properly. In most cases, you should report in strict confidence to ACHĒV’s Chief Executive Officer (CEO). However, if you are not comfortable sending your concern(s) to the CEO or you are not satisfied with the response you received, you are encouraged to report to the Chair or ViceChair of the Board of Directors.  This form is compliant with Achēv’s Privacy and Confidentiality Policy.

REPORT DESTINATION


REPORTER’S CONTACT INFORMATION


Please enter your email, so we can follow up with you.

IMPLICATED PERSON'S INFORMATION


WITNESS INFORMATION (if any)


COMPLAINT: Briefly describe the misconduct / improper activity and how you know about it. Specify what, who, when, where and how. If there is more than one allegation, number each allegation.


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