American Civil Liberties Union of Alaska

Intake Questionnaire

Thank you for contacting the American Civil Liberties Union (ACLU) of Alaska. We are committed to combating unconstitutional conditions and practices, and your complaint is important because it helps us identify problems in Alaska.

Please keep in mind that lawsuits and administrative complaints must be filed within certain time periods. This office cannot provide you with legal advice on how much time you have until you run out of time to file suit. Therefore, it is important to understand that it is your responsibility to seek a legal opinion from a lawyer licensed to practice in the State of Alaska, if you have any questions about how to resolve your legal problem. You may wish to contact the Alaska Bar Association’s Lawyer Referral Service at 272-0352 (1-800-770-9999, outside of Anchorage).

Please complete ALL areas of this inquiry, otherwise the form will not be submitted. Please answer "none" if a question does not apply. All information will be held confidential and will be property of the ACLU. No information will be released without first expressed direction from you.

The ACLU of Alaska will contact you by mail or by email with what services we can provide with respect to your needs.

The ACLU of Alaska is under no obligation to represent you.

Full Name:
Contact Address:
City:
State:
Zip:
Telephone:
Email:
 
Where did this incident occur? (city/county/state):
When did the incident occur?
(be as specific as possible)
What is the problem? (Include names of all people, companies, and/ or government agencies against whom you have a complaint):

Please describe any attempts you have made to resolve this problem. Include names of individuals/agencies and dates, and give a brief description of each result:

Are you represented by an attorney in this matter? If so, indicate the attorney's name and phone number:
May we contact any other individuals, agencies or organziations that may be relevant towards understanding the problem you've written us about? (please answer yes/no)
Is there anyone that you do not want us to contact? if so, tell us who it is:
What kind of help do you want from the ACLU of Alaska?
If you have documents that you believe may help us evaluate your case, please describe them briefly. (We will call you if we want to obtain a copy of the documents):