Complaint form

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Please select your Type : *

Name and Surname : *

Phone number : *

E-mail : *

Country : *

Location : *

Address: *

Age range : *

Nature of the organism : *

what is your sex ? : *

Type of the media : *

Name of the media : *

The name of the program : *

Date of broadcast : *

Time of broadcast PM : *

Web link : *

Violation : *

Explanation of complaint complains : *

Security code :

Please enter the security code : *