Legal Redress Intake Questionnaire
This form is provided as an aide to better address or direct your complaint.The Antelope Valley Branch of the NAACP does not provide legal representation, nor do we provide direct programs and services. However, we often provide referrals to other organizations and individuals that may provide the assistance needed.
Email address *
Name (First, Last) *
Your answer
Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Phone # *
Your answer
Email *
Your answer
Date of Incident *
Your answer
Nature of Incident *
Was the discrimination based on... *
Did the incident happen while at work? *
Do you feel that you are a victim of law enforcement mis-treatment? *
Has a law suit already been filed? *
Required
In two or three sentences,please provide a summary of your complaint. *
Your answer
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