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Class Clown
![]() ![]() Join Date: Feb 2003
Location: Winnipeg, Canada
Posts: 10,200
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SEXUAL HARASSMENT CONSENT FORM Name: __________________ Social Security Number:_______________ Address: __________________________ City:____________________ Department: __________________ Home Phone Number:___________ Office Phone Number: ___________ Male □ Female □ Sexual Orientation: Male / Female □ Male / Male □ Female / Female □ All Of The Above □ None Of The Above - Please Elaborate: _____________ I CONSENT TO THE FOLLOWING FORMS OF SEXUAL HARASSMENT: Salutatory Greetings: □ Eye-To-Eye Contact:□ Eye-To-Bust Contact:□ Eye-To-Crotch Contact:□ Heavy Breathing On: Neck:□ Ear:□ Other:□ Hands On: Body:□ Shoulder:□ Waist:□ Gluteus Maximus:□ Other:□ Feelies:□ Gropies:□ Penetration(However Slight):□ Other:□ All Of The Above:□ MISCELLANEOUS: I WILL: □ I WILL NOT: □ 1. Assist in the procurement of various potions, lotions, products, appliances, etc. to be used during sexual harassment. 2. Assist in procurement and maintenance of various types of electronic or mechanical sustaining apparatus. 3. Clean up. I CERTIFY THAT I WILL ACCEPT SEXUAL HARASSMENT FROM: Anyone: □ Anyone But: ___________________________________ Only: _________________________________________ Signature; ____________________ Date: __________________ This form is to be reviewed by your immediate supervisor annually, prior to performance rating and evaluation. |
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