Get the free Discrimination Intake Form - wcupa

A form for individuals to report discrimination complaints regarding race, religion, sex, national origin, ancestry, age, marital status, sexual orientation, disability, or veteran status.

How to fill out discrimination intake form

How to fill out Discrimination Intake Form

1. Begin by reading the instructions on the Discrimination Intake Form carefully.
2. Fill out your personal information including your name, address, phone number, and email.
3. Specify the type of discrimination being reported (e.g., race, gender, disability).
4. Provide a detailed description of the incident(s) of discrimination, including dates, locations, and names of individuals involved.
5. Include any witnesses to the incident, along with their contact information if possible.
6. Attach any relevant documents or evidence that support your claim.
7. Review the form for accuracy and completeness before submitting.
8. Submit the completed form to the appropriate agency, either by mail or electronically, as specified in the instructions.

Who needs Discrimination Intake Form?

1. Individuals who believe they have experienced discrimination in the workplace, housing, public accommodations, or other areas.
2. Employees seeking to report workplace discrimination to their employer or a government agency.
3. Clients of housing services who have faced discrimination in their housing applications or living conditions.
4. Anyone needing to document an incident of discrimination for future legal or advocacy purposes.

People Also Ask about

What is an example of a discrimination statement?

Applicants, employees and former employees are protected from employment discrimination based on race, color, religion, sex (including pregnancy, sexual orientation, or transgender status), national origin, age (40 or older), disability and genetic information (including family medical history).

What are the 7 grounds of discrimination?

Direct evidence often involves a statement from a decision-maker that expresses a discriminatory motive. Direct evidence can also include express or admitted classifications, in which a recipient explicitly distributes benefits or burdens based on race, color, or national origin.

How do I write a discrimination claim?

You'll want to address the person by name, include the date at the top of the letter, and your name, address, and phone number at the bottom. After the salutation, state the following: A description of the events or incidents you believed to be discriminatory, and when they occurred.

How do you document discrimination?

How to Document Discrimination in the Workplace: A Practical Guide Step 1: Identify the Discriminatory Behavior. Step 2: Keep a Detailed Log. Step 3: Save Relevant Communications. Step 4: Gather Supporting Documentation. Step 5: Report the Discrimination Internally. Step 6: Consult an Employment Lawyer.

What are the 7 grounds of discrimination?

Discriminate on the basis of race, color, religion, sex, national origin, age, disability, marital status, or political affiliation. Solicit or consider employment recommendations based on factors other than personal knowledge or records of job related abilities or characteristics.

What are the 7 types of discrimination and examples?

Ten types of discrimination Age discrimination. Disability. Gender/sexual orientation. Gender identity/gender expression. Genetic information. Military status/military obligations. National origin. Religion.

For pdfFiller’s FAQs

What is Discrimination Intake Form?

The Discrimination Intake Form is a document used to collect information from individuals who believe they have experienced discrimination. It serves as a formal means to report instances of discriminatory behavior or actions.

Who is required to file Discrimination Intake Form?

Individuals who believe they have been subjected to discrimination based on protected characteristics, such as race, gender, age, disability, or sexual orientation, are encouraged to file a Discrimination Intake Form.

How to fill out Discrimination Intake Form?

To fill out a Discrimination Intake Form, individuals should provide detailed information about the discriminatory incident, including the date, location, and nature of the discrimination, as well as personal information such as name and contact details.

What is the purpose of Discrimination Intake Form?

The purpose of the Discrimination Intake Form is to gather necessary information to investigate claims of discrimination and to help authorities take appropriate actions or provide assistance to the individuals affected.

What information must be reported on Discrimination Intake Form?

The information that must be reported on a Discrimination Intake Form typically includes the complainant's personal details, a description of the discriminatory act, the date and location of the incident, and the identity of the discriminating party, if known.