Nondiscrimination & Non-harassment Policy Complaint Form

PCC Nondiscrimination & Non-harassment Policy Complaint Form

Portland Community College prohibits unlawful discrimination based on race, color, religion, ethnicity, use of native language, national origin, sex, marital status, height/weight ratio, disability, veteran status, age, or sexual orientation in any area, activity, or operation of the College. Under the College's Nondiscrimination and Non-harassment Policy, equal opportunity for employment, admission, and participation in the College's benefits and services shall be extended to all persons. For questions or concerns, call our office at 971-722-5840.

Any person who believes he or she has been discriminated against or harassed by a College employee, representative or student is encouraged to submit the Complaint Form. For ADA accommodations, please contact Disability Services at least three working days in advance of request.

Your Information Today's Date: Date of Incident: Name: Address: Phone: Email Address:

Alleged Incident Nature of Complaint: Statement of Alleged Discrimination and/or Harassment: Explain how you were harassed or discriminated against (see Nondiscrimination and Non-harassment Policy). Describe the event(s) that occurred, including specific names, dates, and location. List names and contact information of any person(s) who may have witnessed the incident, if applicable.

I certify that the above information is correct to the best of my knowledge, information, and belief.