Sexual Harassment Form 040447339/TIT/30278837/Grope
Name: _______________________________ SOCIAL SECURITY No:___________
STAFF ELEMENT: ______________________
HOME PHONE No.: _______________________
MALE: ____________ FEMALE: __________
Office Contact No.: _____________________
Male - Female ....
Female - Female ....
Male - Male ....
All of the Above ....
None of the Above - Please Specify: _____________________
I Consent to the following forms of Sexual Harassment:
Salutatory Greeting: _____________________
Eye-to-Eye Contact: ______________________
Eye-to-Bust Contact: _____________________
Eye-to-Below Waist Contact: ______________
Heavy breathing on:
Gluteus Maximus: ________________
Penetration (however slight): ____________
All of the above: ________________________
Misellaneous: I WILL I WILL NOT
1. Assist in procurement of various potions, lotions, products, appliances, etc. to be used during sexual harassment.
2. Assist in procurement and maintenance of various types of sustaining apparatus.
3. Clean up.
I Certify that I will accept Sexual Harassment from:
Anyone But: ________________________________
By applying your signature to this consent form, you will be committing yourself unconditionally to the acceptance of varying degrees of intrusionalistic activities and interest of office perverts, Spoof writers, weirdos, William Hague (if male), Liberal Democrats, and Big Issue sellers.
In the event of the Sexual Harassment being performed or attempted to be performed by any Sexual Harasser who has received any cautions, warnings, prison sentences, criminal charges, suspended sentences, probation, or drinks cheap imported Vodka, and have harassed within the guidelines, rules, and the validity of all clauses within the scope of the neutralisation of the said agreement, will enable the legalisation of any claims you wish to make through the Unemployed Nottingham Consultancy Solicitors, on 0115 962664848
SIGNATURE: _______________________________________ DATE: ___________
This form is to be reviewed by immediate supervisor annually, prior to
performance rating and evaluation.