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Disability or Handicap Discrimination Concern Definition
Form

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Please complete this form so we may begin processing your claim.

I believe that because of my disability or handicap, I have been:

Demoted

Denied Promotion or Advancement

Denied a Raise

Denied Training

Disciplined differently than co-workers who were not disabled.

Given less desirable job assignments than co-workers who were not disabled.

Paid less that co-workers of equal skill and experience, who were not disabled.

Terminated

Treated differently in some other way than co-workers who were not disabled.

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