Skip to content
Menu
Home
About Us
Become a Member
Register to Vote
File a Complaint
Donate Page
Close Menu
File A Complaint
Prefix
Mr.
Mrs.
Ms.
Mx.
Miss
Dr.
Prof.
First Name
Last Name
Email Address
*
Street Address
Apartment, suite, etc
City
State/Province
ZIP / Postal Code
Phone Number
What Was the Cause of the Discrimination?
Race
Age
Sex
National Origin
Gender
Religion
Disability
Retaliation
Other
What date did the Discrimination occur?
What time did the discrimination occur?
Hours
Minutes
AM
PM
Provide sufficient details explaining the incident of discrimination and your request of the NAACP.
Who discriminated against you?
Employer
Law enforcement
Housing
Organization
Agency
Other
Provide the name of the person that acted against you.
Provide a phone # to contact the person that acted against you.
Have You filed a Grievance with a government agency?
Yes
No
Have You filed a Grievance with your union?
Yes
No
If you have retained an attorney, please provide the name of your attorney.
If you have retained an attorney, please provide the Phone # for your attorney.
Are you seeking support for yourself as an individual or support in addressing the widespread issue affecting multiple members in the Fort Worth - Tarrant County community?
I am seeking support for myself as an individual
I am seeking support in addressing the widespread issue
If you are a member of the NAACP, please provide your Membership # and Branch of Affiliation.
By checking below, I affirm that I have read and fully comprehend the above charge and accusation that I am filing and further that it is true to the best of my knowledge based on the information that I have obtained.
I Agree
Send Message
Insert/edit link
Close
Enter the destination URL
URL
Link Text
Open link in a new tab
Or link to existing content
Search
No search term specified. Showing recent items.
Search or use up and down arrow keys to select an item.
Cancel
