U.S. Office of Special Counsel's Certification Program Registration Form

This "U.S. Office of Special Counsel's Certification Program Registration Form" is a United States-specific form released by the U.S. Office of Special Counsel on January 1, 2018.

Download the form by clicking the link below, fill it out by hand, and mail it as per the guidelines provided by the department or the applicable legal instructions.

ADVERTISEMENT
U.S. OFFICE OF SPECIAL COUNSEL
1730 M Street, N.W., Suite 218
Washington, D.C. 20036-4505
(202) 804-7163
certification@osc.gov
U.S. OFFICE OF SPECIAL COUNSEL'S
CERTIFICATION PROGRAM REGISTRATION FORM
The U.S. Office of Special Counsel's (OSC) Certification Program allows federal agencies to meet
the statutory obligation to inform their workforce about the rights and remedies available to them
under the prohibited personnel practice and whistleblower retaliation protection provisions of 5
U.S.C. § 2302. In most cases, agencies should expect to complete the certification process within
six (6) months of registering. If you have any questions about completing this form or OSC's
Certification Program, please contact OSC’s Diversity, Outreach, and Training Unit at
certification@osc.gov
or (202) 804-7163. Instructions for completing the five steps required by
the program are available at https://osc.gov/Pages/2302process.aspx.
• Once registered, OSC requires a monthly update (send to certification@osc.gov) detailing
what progress has been made towards certification.
• Agencies must provide OSC with proposed training and informational materials (if the
materials were not provided by OSC) in advance of dissemination.
• OSC strongly recommends in-person, interactive training, especially for high-level managers
and supervisors (OSC offers training)
• Supervisory training should be tracked to ensure 100% of supervisors have been trained prior
to submitting the compliance form.
General Information
1. Agency or Office Registering:
Agency & OIG
Agency
OIG
Component
Contact Information
2. Please provide the contact information for the official responsible for implementing OSC's
Certification Program (the individual’s name and phone number will be placed on OSC’s
website as the point of contact once the agency is certified).
Name:
Title:
E-mail:
Phone:
Rev. 1/2018
U.S. OFFICE OF SPECIAL COUNSEL
1730 M Street, N.W., Suite 218
Washington, D.C. 20036-4505
(202) 804-7163
certification@osc.gov
U.S. OFFICE OF SPECIAL COUNSEL'S
CERTIFICATION PROGRAM REGISTRATION FORM
The U.S. Office of Special Counsel's (OSC) Certification Program allows federal agencies to meet
the statutory obligation to inform their workforce about the rights and remedies available to them
under the prohibited personnel practice and whistleblower retaliation protection provisions of 5
U.S.C. § 2302. In most cases, agencies should expect to complete the certification process within
six (6) months of registering. If you have any questions about completing this form or OSC's
Certification Program, please contact OSC’s Diversity, Outreach, and Training Unit at
certification@osc.gov
or (202) 804-7163. Instructions for completing the five steps required by
the program are available at https://osc.gov/Pages/2302process.aspx.
• Once registered, OSC requires a monthly update (send to certification@osc.gov) detailing
what progress has been made towards certification.
• Agencies must provide OSC with proposed training and informational materials (if the
materials were not provided by OSC) in advance of dissemination.
• OSC strongly recommends in-person, interactive training, especially for high-level managers
and supervisors (OSC offers training)
• Supervisory training should be tracked to ensure 100% of supervisors have been trained prior
to submitting the compliance form.
General Information
1. Agency or Office Registering:
Agency & OIG
Agency
OIG
Component
Contact Information
2. Please provide the contact information for the official responsible for implementing OSC's
Certification Program (the individual’s name and phone number will be placed on OSC’s
website as the point of contact once the agency is certified).
Name:
Title:
E-mail:
Phone:
Rev. 1/2018
Agency Information
3. List locations of all agency posts of duty (attach separate list if necessary):
4. Number of supervisors in agency
5. Number of non-supervisory employees in agency
6. Target date for completion of program
7. Do all of your employees have email capabilities?
Yes
No
8. Do all of your supervisors have access to the Internet?
Yes
No
9. Does your agency have video-teleconferencing, Skype, or
Yes
No
webcast capabilities?
If so, what percentage of supervisors can be reached?
10. Does your agency sponsor supervisory training?
Yes
No
If so, what percentage of supervisors attends at a given time?
11. In what manner and how often does your agency conduct new employee orientation?
Confirmation of Registration
Signature of Official Responsible for
Date
Implementing OSC's Certification Program
Print
Submit to OSC
Rev. 1/2018

Download U.S. Office of Special Counsel's Certification Program Registration Form

287 times
Rate
4.3(4.3 / 5) 14 votes
ADVERTISEMENT
Page of 2