NAACP LEGAL REDRESS COMPLAINT OF DISCRIMINATION FORM
The NAACP DC Branch does not provide legal representation or legal advice. The Legal Redress Committee is comprised of volunteers that investigate allegations of discrimination that occurred in Washington, DC to determine, what if any advocacy support can be provided by the NAACP DC Branch. We only investigate complaints that occurred in Washington, DC. However, we may provide legal information and referrals to other organizations that may provide the assistance needed. For legal advice, you should consult a local attorney.
FIRST NAME *
Your answer
LAST NAME *
Your answer
MAILING ADDRESS *
Please provide your mailing address, so we can respond to your complaint by mail
Your answer
PHONE # *
Please provide the best phone number to call and contact you
Your answer
EMAIL ADDRESS *
Please provide your email address, so we can respond to your complaint by email
Your answer
LOCATION OF DISCRIMINATION OCCURRENCE *
Where did this act of discrimination occur? The DC Branch Legal Redress is comprised of volunteers that investigate allegations of discrimination that occurred in Washington, DC. We only investigate complaints occurring in Washington, DC.
TYPE OF DISCRIMINATION *
What was the discrimination based on?
Required
DATE OF OCCURRENCE *
What date did the discrimination occur?
MM
/
DD
/
YYYY
TIME OF OCCURRENCE
What time did the discrimination occur?
Time
:
EXPLAIN THE INCIDENT OF DISCRIMINATION *
Provide sufficient details explaining the incident of discrimination and your request of the NAACP
Your answer
ENTITY OF DISCRIMINATION *
Who discriminated against you?
NAME *
Provide the name of the person that acted against you
Your answer
PHONE NUMBER *
Provide a phone # to contact the person that acted against you.
Your answer
HAVE YOU FILED A GRIEVANCE WITH A GOVERNMENT AGENCY?
HAVE YOU FILED A GRIEVANCE WITH YOUR UNION?
HAVE YOU RETAINED AN ATTORNEY FOR YOUR CASE?
ATTORNEY NAME
If you have retained an attorney, please provide the name of your attorney.
Your answer
ATTORNEY PHONE #
If you have retained an attorney, please provide the Phone # for your attorney
Your answer
ARE YOU SEEKING SUPPORT TO YOUR INDIVIDUAL COMPLAINT OR SUPPORT FOR THE WIDESPREAD ISSUE? *
Are you seeking support for yourself as an individual or support in addressing the widespread issue affecting multiple members in the Washington, DC community?
ARE YOU AN NAACP MEMBER? *
Are you a member of the NAACP?
MEMBERSHIP # / BRANCH AFFILIATION
If you are a member of the NAACP, please provide your Membership # and Branch of Affiliation
Your answer
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