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Harassment Reporting Form

Harassment Reporting Form


The ESC of the Western Reserve will vigorously enforce its prohibition against discriminatory harassment based on race, color, national origin, sex, disability, age, (except as authorized by law) religion, ancestry, or genetic information (collectively, "Protected Classes") that are protected by Federal civil rights laws, and encourages those within the ESC community as well as third parties, who feel aggrieved to seek assistance to rectify such problems. 


If you have been subjected to unlawful harassment, you may seek resolution and report a complaint. Please make every effort to file a complaint within thirty (30) calendar days after the conduct occurs while the facts are known and potential witnesses are available.  


Full Name (Not Required)
Phone Number (Not Required)
Email Address (Not Required)
Date of the incident. (Required)
Location of the incident. (Required)
Please describe the incident with as much detail as possible, e.g. who, what, when, where, and how. (Required)

To validate your submission, please answer the following math problem:

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