Columbus State Community College Logo

Concerns of Discrimination, Sexual Harassment and Retaliation


This form may be used by students, employees, faculty, vendors, visitors or other concerned parties to share information related to an alleged incident(s) of discrimination based on a protected class, including sexual harassment, and retaliation for making a report or participating in an investigation of the same. It also may be used to share information related to alleged retaliation against an individual who has exercised their rights under the Americans with Disablities Act and its amendments (ADA/ADAAA) and/or the Family and Medical Leave Act (FMLA) and/or the Pregnant Workers Fairness Act (PWFA).

Sexual harassment includes, but is not limited to, sexual assault, dating violence, domestic violence, stalking. If this is an emergency, please contact the Columbus State Police Department at (614) 287-2525 or, if you are off campus, call 911. Contacting the police does not require you to pursue legal action.

This is a secure reporting format accessible only to the appropriate college officials. You are not required to complete the entire form; however, you must complete fields denoted with an asterisk. The College will use the information provided to address the matter, which means following up with you and/or the affected person and further evaluating to decide upon next steps.

Anonymous reports may be made through this form, but depending on the level of information included in the report, anonymous reporting likely will limit the College’s ability to respond. Employees who are required to make reports under College Procedure 3-44 (A), “Sexual Harassment/Sexual Violence” and Policy 3-43, "Discrimination/Harassment/Retaliation" are not permitted to make such reports anonymously. If an anonymous report includes a crime, it will be counted in the College’s crime statistics.

While any person may use this reporting form, a complainant may use it to submit a Formal Complaint of sexual harassment if they include the elements of a Formal Complaint as described in Procedure 3-44 (A), “Sexual Harassment/Sexual Violence,” Section 13 (b). The Title IX Coordinator or their designee will consult with the complainant to determine if it is appropriate to make a Formal Complaint of sexual harassment, regardless of whether the online report form constitutes a Formal Complaint of sexual harassment.

Prior to completing this form, please review College Policy 3-43, “Discrimination/Harassment/Retaliation,” College Policy 3-44, “Sexual Harassment/Sexual Violence,” and College Procedure 3-44 (A), “Sexual Harassment/Sexual Violence,” found here: http://www.cscc.edu/about/policy/

Students also are encouraged to review the Student Code of Conduct found here: https://www.cscc.edu/services/student-conduct/code-of-conduct.shtml

Background Information

If you wish to identify yourself, please fill in the information listed below. Unless you are an employee who is required to report under Procedure 3-44 (A), “Sexual Harassment/Sexual Violence” or Policy 3-43, "Discrimination/Harassment/Retaliation," you may choose to remain anonymous; however, the College’s investigation and response to anonymous complaints likely will be limited. Record the names and contact information, if known, of all other parties in the “Involved Parties” section.

 
Learn more
For example: student, parent, Associate Professor in BPS
Email address must be of a valid format.
This field is required.
Learn more
What is the role of the person who did the misconduct/discrimination?
This field is required.
This field is required.
Learn more
For Example: Room 114 of Rhodes Hall

Involved Parties

Please state the name and other details (if known) of the person or persons about whom you are reporting and any witnesses and/or other complainants. The complainant is the harmed party and the respondent is the accused party.

Involved party 1

While providing details is essential to addressing your concern, please be advised that some or all of the information you provide in this section may be shared with the person(s) about whom you have the concern.

Please indicate the type of concern per your best estimation.(Required)
You must make at least one selection.
Per your best estimation, please indicate the reason(s) you believe you (or the person on whose behalf you are reporting) have experienced discrimination, harassment or retaliation. If you selected Sexual Harassment for the question above, please select it again here. Please note, this form does not address general complaints related to conflicts in your academic or work environment that are not directly related to the categories stated on this form.(Required)
You must make at least one selection.
This field is required.
This field is required.
Per your knowledge, was a police report filed about this matter?(Required)
You must make at least one selection.
Have you discussed this complaint with any college official?(Required)
You must make at least one selection.
This field is required.
By checking the box below and submitting this form, you certify that the information you have provided is true and accurate to the best of your knowledge.(Required)
You must make at least one selection.

Supporting Documentation

Please note, if you submit documentation related to an allegation of sexual harassment, in order for the College to use the documentation to address the allegation, the Compliance Office must share the documentation with the accused person (respondent). 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission