HSAC NAACP Complaint FormPlease accurately enter the details of your complaint so we can best serve you! Name * First Name Last Name Email * Briefly explain your primary issue in two sentences below * Address Address 1 Address 2 City State/Province Zip/Postal Code Country Date of Birth * MM DD YYYY Preferred Phone (###) ### #### Preferred communication method Email Phone Are you currently an HSAC NAACP Member? Yes No Please provide a brief description of what happened. Do you have witnesses who can support your claim? If so, state their names, addresses, phone numbers, and the pertinent information they can provide. Do you have documents or other evidence to support your claim? If yes, prepare to send it via email when we reach out to you. Yes No Have you tried to resiolve your complaint through a formal or informal grievance procedure? Yes No If yes, what was the outcome? By checking the box below, I certify that this information is true and correct to the best of my knowledge. The NAACP will carefully evaluate your allegations to determine if a formal investigation will be initiated. If the NAACP does not open an investigation, this action should not be considered a determination of the merits of your allegations or the results of any finding of fact or law. The NAACP, by way of accepting this document, does not assume responsibility for representation or to give legal advice. The NAACP will utilize is resources and best judgement to educate community members about their options about their conflicts and access to the legal process Thank you! We will reach out to you as soon as possible.
