The Metropolitan Human Relations Commission
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The alleged discrimination occurred in
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Employment
Housing
Public Accommodation
School
Full Name (including middle initial)
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Permanent Address
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City
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State
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Zip Code
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Phone
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Work Phone
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Cell Phone
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Email
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Date of Birth
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Please provide the name of someone not living in your home who knows where you are at anytime
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Phone
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Address
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City
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State
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Zip Code
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Relationship
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PLEASE PROVIDE the REASON for the difference in treatment: (check all that apply)
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Race or Color
National Origin
Ancestry
Place of Birth
Religion
Age
Disability
Pregnancy
Equal Pay Issue
Sex
Retaliation
Familial Status(Housing only)
Sexual Orientation
Sexual Harassment
Date of Incident/Discrimination
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I learned about this agency by
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If you are charging an Employer with discrimination, are you currently employed with them?
Yes
No
Does Not Apply
If charging a Housing Provider with discrimination, are you facing eviction?
Yes
No
Does Not Apply
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Laws
Title VII of the Civil Rights Act of 1964
Metro's Rules & Regulations
Fair Housing Act
Equal Pay Act of 1963
Civil Rights Act of 1991
Fort Wayne City Ordinance
Age Discrimination in Employment Act of 1967
Americans with Disabilities Act Amendments Act 2008
