I would like to report and discuss a DISCRIMINATION COMPLAINT with the Hocking.Athens.Perry Fair Housing Consortium.

Name:
Address:
City: State: Zip:
Phone:

How do you feel you were discriminated against?
(Please check all that apply)

Race/Color Physical/Mental Disability Religion
National Origin Family Status Sex

How were you discriminated against?

Rental of Housing Sale of Housing
Housing-Related Services Other