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ACLU Complaint Form
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Your Contact Information - Note: If completing this form on behalf of a loved one or friend that is incarcerated, please include their Inmate DOC Number
DOC Number
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Email
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First Name
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Last Name
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Phone Number
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Cell Number
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Address
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Address Line 2
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City
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State
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Zip Code
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Country
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United States
Canada
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Race - Select all that apply
White, Non-Hispanic
African American, Non-Hispanic
Asian
Hispanic
American Indian/Native Alaskan
Native Hawaiian And Pacific Islander
Complaint Information
Enter information about the person or agency you are complaining against.
First Name
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Last Name
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First Name
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Last Name
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Agency
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Phone Number
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Address
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Address Line 2
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City
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State
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Zip Code
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Country
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United States
Canada
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Complaint Overview
Issue
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School-to-Prison Pipeline (Education Issues) – Hayti, MO
School-to-Prison Pipeline (Education Issues) – St. Louis, MO
REPRO
LGBTQ
Voting Rights/Expungement
Criminal Matters
Discrimination
Employment
Immigration
Religion
Education
Other
Date
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People and Actions - Select all that apply
I have witnesses and contact information
I am represented by an attorney in this matter
A lawsuit regarding this complaint has been filed
Provide a complete description of your complaint. Describe in detail, the events that lead you to file this complaint. If you have additional documents to support your complaint, please list them. Please send, via email, supporting documents to intake@aclu-mo.org. Include in the subject line the Last Name and First Name. Please do not send documents via U.S. mail.
Complaint Details
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Desired ACLU Action
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The information I have provided to the ACLU of Missouri (“ACLU”) is true and correct to the best of my knowledge, and I authorize the ACLU to use that information as necessary to determine whether it will offer me legal or other assistance.
I understand that, by receiving this complaint, the ACLU is not agreeing to represent me in any legal proceeding of any kind. Moreover, I understand and agree that the ACLU is not responsible for ensuring that any statute of limitations requirements are met in my case or that any court deadlines are met in any currently pending case or other legal proceeding I may have.
I understand that (1) email communication is not a secure method of communication; (2) any email that is sent to me or by me may be copied and held by various computers the email passes through as it goes from sender to recipient; and (3) persons not participating in our communications may intercept our communications by improperly accessing my computer, the ACLU's computers, or even some computer unconnected to either of us that the email passes through. By providing my email address to the ACLU, I authorize it to communicate with me by email.
I have read and fully understand the Information and Authorization presented above.
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Complaint Location
Address
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Address Line 2
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City
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State
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Zip Code
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Country
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United States
Canada
Mexico
Email
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