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Human Rights


Complaint Form

People's hands together, photoCitizens experiencing discrimination or harassment or who have another human rights concern, can contact the Commission at (503) 588-6261, appear in person before the Human Rights & Relations Advisory Commission, or fill out and submit the report below to alert the Commission about their complaint. The Commission Staff and HRRAC Commissioners will meet with the complainant and discuss options and ways to resolve the problem.

 

 

 

 

 

 

 

 

 

PLEASE FILL OUT THIS INCIDENT COMPLAINT FORM AND SUBMIT IT
 

 

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?

 

 

Emergency
Information

 


All Parks, Recreation, & Community Services Events

 

 

Parks, Recreation, &
Community Services
555 Liberty St SE
Room 300
Salem, OR 97301
503-588-6261
communityservices
@cityofsalem.net

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Page Last Modified: January 25, 2007

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