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ADA Commendation/Complaint Form – Corpus Christi Regional Transportation Authority
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ADA Commendation/Complaint Form

ADA Commendation/Complaint Form

ADA Formulario de Elogio/Queja

Non-Discrimination Policy Notice (Title VI)

    Name / Nombre ★
    First / El nombre primero
    Last / Apellido
    Address / Dirección
    Street Address/Dirección
    Address Line 2/Dirección Segunda
    City/Ciudad
    State/Province/Region [Estado/Provincia/Región]
    Postal / Zip Code[Código postal]
    Country / Region [país / región]
    Email / el e-mail ★
    Date of Incident / Fecha del incidente ★
    Time of Incident / Hora del incidente ★
    Route Number / Numero de ruta
    Bus Number / Número de autobús
    Direction of Travel / Dirección de viaje
    Describe the Incident / Describe el incidente ★
    Desired outcome / Resultado deseado ★