From buddy Mon Nov 7 19:47:13 1994 Date: Sat, 5 Nov 1994 03:49:55 Subject: sexual harassment permission form THE SEXUAL HARASSMENT CONSENT FORM Name: _______________________________ SOCIAL SECURITY No: ___________________ ADDRESS: ____________________________ CITY: _________________________________ STAFF ELEMENT: ______________________ HOME PHONE No.: _______________________ MALE: ____________ FEMALE: __________ OFFICE PHONE No.: _____________________ SEXUAL PREFERENCE: 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 neck: _________________ ear: __________________ other: ________________ Hands on body: ___________________________ shoulder: _______________________ waist: __________________________ Gluteus Maximus: ________________ other: __________________________ Feelies: _________________________________ Gropies: _________________________________ Penetration (however slight): ____________ Other: ___________________________________ All of the above: ________________________ MISCELLANEOUS: 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: ____________________________________ Anyone But: ________________________________ Only: ______________________________________ SIGNATURE: _______________________________________ DATE: ____________________ This form is to be reviewed by immediate supervisor annually, prior to performance rating and evaluation.