City of Kirkwood - Human Rights Complaint Form [mockup page]
Have You Been Treated Unfairly?  
We are making some additional proposed changes in related areas of Human Rights and Relations
including Web pages like this one to let Kirkwood citizens know how much the community wants and cares for each individual.

Complaint Form

Citizens experiencing discrimination or harassment or who have another human rights concern, can contact the Commission at (314) 822 xxx, appear in person before the Kirkwood Human Rights Advisory And Awareness Commission (HRAAC) , or fill out and submit the report below to alert the Commission about their complaint. The Commission Staff and HRAAC Commissioners will meet with the complainant and discuss options and ways to resolve the problem.


 
 
 
 

WORK IN PROGRESS EMAIL wt@kmhr.us FOR INFO!

PLEASE FILL OUT THIS INCIDENT COMPLAINT FORM AND SUBMIT IT

DOES NOT WORK YET

 

 

1. Your Name:      

 

2. Your Address:

Street:

City: State: Zip:

 

3. Phone Numbers:

Home: Work:

 

4.  E-Mail Address: 

 

5.  On what date did the incident occur:

 

6.  Please the describe the incident, including names of those involved:


7. Have you filed this complaint with other authorities? Yes No

 

8. If Yes, with whom?

 

9. What has been done to try to resolve this complaint?

 

 

10. What is your desired outcome of this complaint?

 

Page Last Modified: xxx 200x

 

The City of Kirkwood values all persons without regard to race, color, religion, national origin, sex, age, marital status, domestic partnership, disability, familial status, sexual orientation, gender identity and source of income.
 
 
 
*Committee for Unity for past information
 
 
 
<

Copyright © 2008 Committee for Unity/WVT, All Rights Reserved