Employment Complaint Please Note: The HRC can only investigate complaints in Lexington, Fayette County, Kentucky Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Email Date of Birth MM DD YYYY Company Name * Company you are filing against Company Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Company Phone (###) ### #### When did the discriminatory act occur? * MM DD YYYY You feel you were discriminated against based on your: * Race Color Age (40+) National Origin Religion Sex Disability - mental Disability - physical Pregnancy Sexual Harassment Sexual Orientation or Gender Identity Retaliation Protective Hairstyle (CROWN Act) What action was taken against you that you feel was discriminatory? * How did you find out about the Human Rights Commission * Internet/Commission website Social media Radio Television From a friend/family member Referral from another agency From a lawyer Billboard/bus advertisement Commission booth at community event Thank you!