Complaint Form

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Complaint Form

Thank you for contacting the NAACP Camden County Branch (Unit 5177). Please explain your problem or concern by completing the form below.

The mission of the NAACP is to achieve equity, political rights, and social inclusion by advancing policies and practices that expand human and civil rights, eliminate discrimination, and accelerate the well-being, education, and economic security of Black people and all persons of color.

Email *

First Name *

Last Name *

Phone Number *

Primary Area of Discrimination (Please select) *

How you were mistreated, harassed, or discriminated against?

RELEASE AND WAIVER OF LIABILITY

I affirm that the statements that I have made above are accurate and true to the best of my knowledge and belief. I hereby request the assistance of the NAACP Camden County Branch in seeking a remedy to the situation described above. I hereby authorize the officers of the NAACP Camden County Branch to have access to information and documents, which are relevant to my claim of discrimination described above. I understand that once a referral has been made to a volunteer, community agency or private attorney, the NAACP Camden County Branch WILL NOT BE RESPONSIBLE for handling this matter. I further understand that by signing this document, I am agreeing to HOLD the NAACP Camden County Branch harmless for any and all damages arising as a result of my case being mishandled, negligently handled or improperly handled in any way.

NON-RETALIATION REQUIREMENTS

Section 704 (a) of the Civil Rights Act of 1964, (as amended), Section 4 (d) of the Age Discrimination in Employment Act of 1967, (as amended), and various other civil rights laws make it an unlawful employment practice for an employer; employment agency; or labor organization: to discriminate against employees, applicants for employment, member or applicant for membership, because the employee, member or applicant has opposed an unlawful employment practice, made a charge, testified, assisted, or participated in any manner in an investigation, proceeding or hearing.

COMPLETION OF THIS FORM

Completing this form does not constitute filing an official complaint with a legal authority. At this time the NAACP Camden County Branch is ONLY seeking information to assist you concerning this complaint.

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