This is an authorization form. By signing the form below, you,

(Legal name of aggrieved party) authorize UNITED SIKHS to solely engage with or your attorney in the case outlined below.
In relation to religious freedom issues, you authorize UNITED SIKHS to be involved in discussions to make decisions with an agency at issue or a named Attorney or other representative and yourself to ensure that the larger community's non-legal interests are served on matters which appertain the freedom to practice the Sikh faith, religion and culture.
By signing this form, you agree to involve UNITED SIKHS or the attorney appointed by UNITED SIKHS in any meeting or in any direct or indirect negotiations or discussions with any party related to this issue.
UNITED SIKHS shall be responsible for issuing any public statement, in consultation with you, made via the media or otherwise on the actions undertaken by a UNITED SIKHS representative or Named Attorney on your behalf, pursuant to this authorization.
You authorize UNITED SIKHS to use your picture taken for highlighting the case facts and for causes that are within the advocacy mission and vision of UNITED SIKHS.
You will be consulted if any lawyers have to be hired and their costs will have to be agreed separately. If you are unable to meet all or part of the costs, you authorize UNITED SIKHS to fundraise for any costs, including litigation costs, pursuant to this authorization.
If there is a settlement or judgment in your favor, you agree to donate your dasvandh or amount later agreed upon to the UNITED SIKHS to meet administrative and advocacy costs.
This agreement shall not be interpreted in any way that violates any relevant professional code of conduct that governs client-attorney relationship between you and your attorney assigned by you or by UNITED SIKHS in consultation with you. Ultimate decision on the matter rests with you and your attorney.
You shall indemnify, defend and hold harmless UNITED SIKHS and its officers, directors, agents and employees from and against claims, damages, losses and expenses, including but not limited to attorneys' fees, arising out of or resulting from the negligence or misconduct of the Attorney or if you lose the case in connection with performance of the work described in this Agreement.

You hereby authorize UNITED SIKHS on the above terms. Please join UNITED SIKHS by filling a form at www.unitedsikhs.org/join, Your Name

Designation/aggrieved party/parent/guardian of person you represent

Your Address

Your Telephone Number

Your email

Case Outline (Use A Continuation Sheet, IF NECESSARY – Meaning just answer the questions on another blank sheet):

Name of aggrieved party

Contact Details: (if different from above)

Address

Tel no’s

Email

Description of incident/issue for which representation is sought (use additional sheet if necessary)
Hate crimes

What is the right or remedy that you are asking UNITED SIKHS to obtain?

Do you have any supporting documents e.g. correspondence etc?

On what grounds are you seeking to establish the remedy or right for which you are instructing? UNITED SIKHS?

Please provide the names and contact details of person(s) or organizations that have deprived you of or violated your rights that you are seeking remedy for (e.g. employer’s details, School principal’s details etc):

What is the full name and address of your local Gurdwara (your personal details will not be shared with any third? Party without your permission):

Please provide details of any other person or organization that you have sought help from, so that we may avoid duplication.

CONSENT/AUTHORIZATION FORM