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BlackGirlsInk - Intake form for Black women experiencing discrimination and anti-Black racism

Greetings ladies:

BlackGirlsInk and ANCHOR are working together to support over twenty Black women who have either been discriminated against at work, faced anti-Black racism, sexism sexual assault, sexual harassment, Misogynoir and corporate harassment. We are also supporting women who have been looked over for promotions, demoted, faced unfair treatment, surveillance, sabotage, and other forms of workplace discrimination and harassment. We have a legal team ready to confront these companies but we need to ensure we have all the details for each client. This form is confidential.  The contents of this form, and all responses will not be shared with anyone other than our lawyers.  The issues you share will be used to support our case but no names and personal information will be shared. Please complete all the questions below.  

Thank you,

BlackGirlsInk

blackgirlsink.com

anchorcanada.com


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Email *
"Each time we stand up against injustice, we walk in the footsteps of our ancestors and leave the wind behind for our future generations, so that they will breathe easier and walk stronger." - Elder quote
Full name *
Address *
Mobile phone number *
How did you hear about BlackGirlsInk?
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Click on the sentence that best describes your issue?
 *
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Are you interested in a virtual or in person meeting? (location Vaughan) *
Which day of the week do you prefer? *
Required
Please state what time you are available for an intake consultation? *
Please include all the pertinent details of your situation. Include names, dates, location and what happened. Include any copies or attachments. *
 Are you comfortable being a part of our lawsuit? *
Have you contacted other agencies for support? If so, please list them here. *
Can you attend meetings with our lawyers to share your story? *
What recourse are you looking for? Do you have a resolution that you would like to happen so you can have closure or accountability? What support do you need from BlackGirlsInk? *
Is there anything else you would like to add? *
*
Thank you for completing our intake form.  Your responses will help us to build a strong case for this lawsuit and seek justice on your behalf.
In Solidarity, 
By signing below you are sharing your story with BlackGirlsInk and ANCHOR to use in our claim against workplace discrimination against Black women. You are  providing BlackGirlsInk and ANCHOR your permission to represent your interest in our ongoing fight towards justice for Black women facing discrimination in the workplace. This may include social media posts, virtual and in-person meetings, media interviews, emails, letters, photos, videos, interviews and legal representation. As your representative we will ensure transparency and accountability as we seek justice.  Please sign below: *
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