WhistleBlowing Form

REPORT ON
IMPROPER CONDUCT,
WRONGDOINGS, BRIBERY,CORRUPTION, FRAUD,
OR ABUSE OF POWER/AUTHORITY

REPORTING CHANNELS

 
OPTION 1
 
Report directly to the Executive Directors.
Please select the Executive Director you would like your report to be sent to :-
 


 
OR
 
OPTION 2
 
Immediately raise your concerns to the Whistleblowing Committee e-mail at :-
 
 
   

Please provide the following details for any suspected serious misconduct, breach or our Code of Conduct, Anti-Corruption policy or and other suspected breach of law or regulation that you are concerned may adversely impact our organisation.

Note: Please follow the guidelines as laid out in the above Whistleblowing Policy

* Required Information

Part A – WHISTLEBLOWER’S CONTACT INFORMATION
(This section may be left blank if the reporter wishes to remain anonymous)
Name :

Designation :

Department :

Contact Number :

E-mail Address* :
Part B - SUSPECT’S INFORMATION
Name* :

Designation :

Department* :

Contact Number :

E-mail Address :
Part C – WITNESSES’S INFORMATION (if any)
Name :

Designation :

Department :

Contact Number :

E-mail Address :
Part D - 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 and use as many pages as necessary.
1. What misconduct / improper activity occurred?*

2. Who committed the misconduct / improper activity?*

3. When did it happen and when did you notice it?*

4. Where did it happen?*

5. Is there any evidence that you could provide us?

6. Are there any other parties involved other than the suspect stated above?

7. Do you have any other details or information which would assist us in the investigation?

8. Any other comments?

Date :
NOTE: It is your right to remain anonymous and our organisation respects and protects this right of yours to protect your anonymity. However, we encourage you to share your identify (or personal e-mail address at the very least) so that we can keep you updated on the status of your report as well as follow up with you should we require additional information.