SEXUAL HARASSMENT CONSENT FORM
 
 NAME ___________________________   SOCIAL SECURITY NUMBER__________
 ADDRESS ________________________   HOME PHONE _____________________
                     ________________________   WORK PHONE
_____________________
 
 MALE _____ FEMALE _____   OTHER __________________________
 
      SEXUAL PREFERENCE:
 
      MALE-FEMALE _______________   FEMALE-FEMALE __________________
      MALE-MALE _________________   HUMAN-ANIMAL ___________________
      ALL OF THE ABOVE __________   NONE OF THE ABOVE ______________
      OTHER (SPECIFY) ______________________________________________
 
 I CONSENT TO THE FOLLOWING FORMS OF SEXUAL HARASSMENT:
 
 SALUTORY GREETING ______________       HEAVY BREATHING ON:
 OCCASIONAL COMPLIMENTS _________             NECK ________________
 EYE-TO-EYE CONTACT _____________               EAR _________________
 EYE-TO-BUST CONTACT ____________              OTHER _______________
 PINCHING/RUBBING _______________
 GROPING ________________________       HANDS ALLOWED ON: 
 HEAVY GROPING __________________            SHOULDER ____________
 OTHER (SPECIFY) ________________               ARMS ________________
 ALL OF THE ABOVE _______________               WAIST _______________
                                                                              
BUNS ________________
                                                                              
BOOBS _______________
                                                                              
OTHER (SPECIFY BELOW)
                                                                              
_____________________
 
 I WILL _____ WILL NOT _____
 
 1. ASSIST IN THE PROCUREMENT OF VARIOUS POTIONS, LOTIONS, AND OTHER PRODUCTS
TO BE USED DURING MY SEXUAL HARASSMENT.
 2. ASSIST IN THE PROCUREMENT AND MAINTENANCE OF VARIOUS TYPES OF
PARAPHERNALIA TO BE USED DURING MY SEXUAL HARASSMENT.
 3. PARTICIPATE IN TRAINING DEMONSTRATIONS.
 4. CLEAN UP.
 5. SERVE POST-HARASSMENT REFRESHMENTS (LIMITED TO COFFEE, SOFT DRINKS,
CIGARETTES, COOKIES, ETC.)
 
 I WILL ACCEPT SEXUAL HARASSMENT FROM THE FOLLOWING: _______________
 
 ___________________________________________________________________
 
 
 SIGNATURE: ______________________________    DATE: ________________
 
 (NOTE: A NEW CONSENT FORM MUST BE FILED WITH THE PERSONNEL OFFICE
        WHENEVER ANY OF THE ABOVE INFORMATION CHANGES)