RCMP Class Action Lawsuit Registration Form



Please be very careful to be accurate in completing this Registration Form as any errors may result in disqualification from the opportunity of being one of our clients in this Class Action.



Name*

Date Of Birth*

What is your biological sex?*



What gender do you publicly identify as?*



Address*



Contact Information



Have you ever worked in a position supervised or managed by the RCMP, or worked in a RCMP controlled workplace (e.g. a RCMP detachment, office or facility, etc.) at any time from September 19, 1974 to date? *

Please indicate if you have worked in any one or more of the following positions(please check any and all that may apply):*


Are you a current or former member of the Canadian Armed Forces (CAF), RCMP or Federal Public Service (FPS)? *

Have you been subjected to gender based discrimination and/or harassment while working with the RCMP?*



Have you been subjected to sexual orientation based discrimination and/or harassment while working with the RCMP?*



Please describe the harassment and/or discrimination you experienced.

i.e.. Because you are a female or identify as one. If you qualify as a client for Higgerty Law, we will obtain supplemental information from you directly  *Please note this is not a mandatory field.

How have you been adversely affected as a result of the gender and/or sexual orientation based harassment/discriminatory behavior?

i.e. Because of your sexual preference. (e.g post-traumatic stress, substance abuse, feelings of anxiety, nightmares, occasional panic attacks,feeling of humiliation and rage, loss of self esteem etc.,) If you qualify as a client for Higgerty Law, we will obtain supplemental information from you directly  *Please note this is not a mandatory field.

Have you been compensated in any civil claim, grievance or harassment complaint with respect to the same events and injuries as you wish to claim under this Settlement?



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