New Albany Commission on Human Rights - Discrimination Complaint Form
If you believe that you've been discriminated against based upon your race, color, religion, national origin, sex, age, disability, familial status, sexual orientation, gender identity, or veteran/military status in employment, housing, education, or public accommodations, within the City of New Albany, you may submit an initial complaint using this form. A representative of the New Albany Commission on Human Rights will be in touch with you within one week after your complaint form is received to schedule further steps.
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Your full name *
Your address
Your phone number
Your email address
What is the best way and time for us to contact you about this complaint?
What type of discrimination do you believe you experienced? *
Required
Who do you believe discriminated against you? *
Required
What do you believe was the basis of the discrimination? *
Required
Please provide a detailed description of the incident(s) of discrimination. What happened to you? How were you discriminated against? *
Did the incident(s) you described above happen in New Albany? If not, please explain where it/they happened. *
What do you want the New Albany Commission on Human Rights to do about your complaint? *
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