SEXUAL HARASSMENT CONSENT FORM

Name: Department: Employee No:  Male

 Female
Address: City: ST Zip:

Home Ph: Mobile Ph: Work Ph:

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

 No Restrictions  Other:
 Feelies  Gropies  Penetration (however slight)

 All of the Above  None of the Above  Other:

I CERTIFY THAT I WILL ACCEPT SEXUAL HARASSMENT FROM

 Anyone  Anyone, but:  Only:

MISCELLANEOUS
I  WILL /  WILL NOT: Assist in procurement of various potions, lotions, products, appliances, etc. to be
used during sexual harassment.
I  WILL /  WILL NOT: Assist in procurement and maintenance of various types of sustaining apparatus.
I  WILL /  WILL NOT: Clean up.

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 has harassed within the guidelines, rules, and the validity of all clauses within
the scope of the neutralization of the said agreement, will enable the legalization of any claims you wish to make.

Caution: 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.
Signature: Date:

This form is to be reviewed by immediate supervisor prior to annual performance rating and evaluation.