Please enable JavaScript in your browser to complete this form.Police Officer Name *FirstLastReferring Police Service Name *Badge Number *Email *Police Contact Phone *Brief Synopsis Of Incident and Reason For Referral *Accused's Name *FirstLastAccused's Age *Parent/Guardian Names and Contact DetailsIf the accused is a youth within the definition of the YCJA, please include parent/guardian names and contact details aboveVictim Information *Please provide the names and contact details for the victims relating to this incident and subsequent referral.Submit
