ICCS WEB SITE Certification Application

iWatchDog™
Complaint Form

Entering a complaint regarding an iWatchDog™ Program licensee Web site or other person / company that you believe is not practicing business in an ethical manner, reporting a person(s) putting children at risk, is a serious statement. Please fill out this form in it's entirety and as accurate in details as possible. This will enable us to process your complaint in an expeditious, yet fair manner to a mutual positive resolve.

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Complaint Type

 Web Site Violation
  ICCS License Violation
  General Consumer Complaint
  ChildSafety Issue

Have you read and understand the terms and conditions set forth in the
ICCS Certification Terms and Conditions?  Yes   No

If your answer is "NO", then CLICK HERE - Agreement to these terms is 
mandatory for qualification to get your web site certified.

In order to be consistent with the iWatchDog™ Program Content Policy Guidelines,

We are unable to take personal information from a person who is age 13 or under without permission from their parent or guardian. By your filling out this form, you are agreeing to these terms and are legally identifiable and are over 13 years of age.

Have you read the UFCWS Privacy Statement? Yes No

If your answer is "NO" we have provided a link to our Privacy Statement
for your convenience so you can become more familiar with how we use the
            information on these forms.

PERSON FILING COMPLAINT

E-Mail Address
Company
YOUR URL
Web Site Type

Primary Connection

Name
Phone
Address line 1
Address line 2
City
State/Province
Zip/Postal
Country

In order for us to properly and effectively resolve your
            complaint we need accurate information.  Please enter the
            following information about the company you are filing against.

COMPANY OR PERSON YOU ARE FILING A CLAIM AGAINST

E-Mail Address
Company
YOUR URL
Web Site Type

Primary Connection

Contact Name
Phone
Address line 1
Address line 2
City
State/Province
Zip/Postal
Country

Please describe your complaint...

Note: Be sure to press the Enter key at the end of each line in the

Comments Section, so we don't lose anything.

Comments:

What do you feel is a fair resolve?

Note: Be sure to press the Enter key at the end of each line in the

Comments Section, so we don't lose anything.

Comments:

To get to the bottom of your reported complaint, it may be a requirement for the UFCWS
to disclose portions of your complaint to the Web site licensee, including your name or
email address. However, we WON'T give out this information unless you provide your
permission below.

May we give your email address or name to the organization you named above
if it is necessary to resolve your complaint?

YES, if resolving the complaint requires that the UFCWS give my name or email
address to the Web site named above, I give my permission for the UFCWS to do so.

No, I do not want my name or email address given to the Web site named above,

even if it means that the iWatchDog program may not be able to fully resolve the issue.
Note: If you don't want your name or email address given out, the UFCWS will still attempt to resolve your complaint in a expedient manner.

To expedite a resolution, in some cases the UFCWS may request that the Web site in question contact you directly. If needed, can we ask the Web site to contact you directly?

YES, if the Web site can work with me directly to best resolve this issue, you may have them contact me directly.

No, I do not want the Web site to contact me directly.

Thank you for completing the UFCWS iWatchDog form.  We appreciate your participation
            in our iWatchDog process.  We will send you a confirmation of receipt of your watchdog
            report following our initial contact with the company you are complaining against.  Please
            do not attempt to call the UFCWS about your complaint.  If we determine that your
            complaint is not eligible for resolution by the iWatchDog program, we will try our best to
            refer you to a more appropriate resource.

United Federation of ChildSafe Web Sites, Inc. Copyright © 2001 United Federation of ChildSafe Web Sites All rights reserved.

United Federation of ChildSafe Web Sites, Inc.
Copyright © 2001 United Federation of ChildSafe Web Sites
All rights reserved.