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Get General Intake Questionnaire Fair Employment Program

33 Labor Standards 851 Werner Court Suite 121 Casper, WY 82601 (307) 235-3679 FAX (307) 235-3688 DATE: _________________________ Please answer the following questions telling us briefly why you believe you have been discriminated against by your employer or potential employer. After you complete this questionnaire, submit the signed document to THE NEAREST OFFICE at the address noted above. UNDER STATE LAW, YOU HAVE SIX (6) MONTHS FROM THE LAST DISCRIMINATORY ACT IN WHICH TO FILE A VERIFIED CO.

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