Case of DiscriminationReport a Case of DiscriminationPlease enable JavaScript in your browser to complete this form.Name *FirstLastDate of Birthdd/mm/yyyyCitizenshipSexTelephone numberEmail *AddressInformation about your ComplaintName of the person/company/organization who you allege discriminated against you, or your explanation for not being able to identify him/her. Reason for alleged discrimination against you *SexRaceColourEthnicityLanguageGender identitySexual orientationPolitical affiliationReligious backgroundPhilosophical backgroundEconomic statusEducation statusSocial statusPregnancyFamily backgroundParental responsibilityAgeFamily statusMarriage statusCivil statusPlace of residenceHealth statusGenetic dispositionDisabilityMembership in a special group• Explanation of facts about your alleged discriminationThe date when the discrimination took placedd/mm/yyyyEmailSubmit