Grievance Form - Columbus DSA

Full Name

Phone Number

Zip Code

Accused

Person(s) (up to five names separated by commas) or DSA body (Steering Committee, Caucus, etc) against whom you are filing a grievance, or put "anonymous/unknown."

Witnesses

Persons (up to five names, separated by commas, of people with direct knowledge of the facts relating to your grievance)

Yes No

Complaint

Tell us about what happened. Please be as specific as possible, including the Who, What, Where, Why, and How of what happened. Remember that DSA is committed to creating a space that is welcoming and inclusive to members of all genders, races, and classes: why did that not happen in the situation you have described? Please try to be concise -- if you have additional documents to submit, you will be asked when speaking with the chapter harassment grievance officers (HGOs) to submit them at that time.