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Sexual Harassment/Discrimination Form
Please complete the form below. Required fields marked with an asterisk *
Name
*
Answer Required
Job Title
*
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Work Address
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Work Phone
*
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Email
*
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Your complaint of Sexual Harassment is made about:
*
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Please describe what happened and how it is affecting you and your work. Please send any relevant documents or evidence to smurray@okolona.k12.ms.us
*
Answer Required
Date(s) sexual harassment occurred:
*
Answer Required
Is the sexual harassment continuing?
*
Answer Required
Please Select
Yes
No
Please list the name and contact information of any witnesses or individuals who may have information related to your complaint:
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Optional: Have you previously complained or provided information verbal or written about related incidents? If yes, when and to whom did you complain or provide information?
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If you have retained legal counsel and would like us to work with them, please provide their contact information
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Confirmation Email
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