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Tel.: (405) 235-5200
Please fill in as much as you can, then press Send below: |
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Your Name: |
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Your Email (required): |
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Your Phone (required): |
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Gender: |
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Race: |
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Age: |
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What type of discrimination, while you were employed, caused you to suffer financial harm?: |
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What type of discrimination, while your were employed, caused you emotional injuries or lost income in any manner?
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How many employees did your employer have at the time you were discriminated
against?: |
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Did you report the discrimination to the supervisors of the department where you
worked and/or a higher management official in employer organization?: |
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If you reported the discrimination to management, were you retaliated against by
termination, job shift, demotion, etc.?: |
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On what dates did these acts of discrimination and/or retaliation occur? List the exact
month, day and year. |
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Send to Attorney: |
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