OSC Seal
UNITED STATES
OFFICE OF SPECIAL COUNSEL

2302(c) CERTIFICATION PROGRAM 

REGISTRATION FORM

Informing Employees about the Whistleblower Protection Act
The OSC 2302(c) Certification Program allows federal agencies to meet the statutory obligation to inform their workforces about the rights and remedies available to them under the prohibited personnel practice and whistleblower retaliation protection provisions of 5 U.S.C. 2302(c).  To register in the program fill out this form and fax it to Shirine Moazed at (202) 653-5161.  Questions about the program or completing this form should be directed to Shirine Moazed at (202) 254-3600

1. Name of agency:

_________________________________________________________________

2. Name, title, e-mail address and phone number of official responsible for implementing 2302(c) program (If more than one – please list):

Name: ___________________________________________________________

Title: ____________________________________________________________

E-mail: ___________________________________________________________

Phone: ___________________________________________________________

 

3. List locations of all agency posts of duty (Attach separate list if necessary):

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________


4. Number of supervisors in agency:

_________________________________________________________________

 

5. Number of nonsupervisory employees in agency:

_________________________________________________________________

 

 

REGISTRATION FORM

2302 (c) Certification Program

6. Target date for completion of program:

_________________________________________________________________

 

7. Do all of your employees have e-mail capabilities? 

_________________________________________________________________

8. Do all of your supervisors have access to the Internet? 

_________________________________________________________________

9. Does your agency have satellite broadcasting capabilities? If so, what percentage of supervisors can be reached by satellite broadcasting?

_________________________________________________________________

10. Does your agency sponsor supervisory training? If so, what percentage of supervisors  attend at a given time?

_________________________________________________________________

 

11. In what manner and how often does your agency conduct new employee orientation?

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

 

____________________
Date

_____________________________________
Signature of Official Responsible for
Implementing 2302(c) Certification Program

 

12. Is your agency interested in receiving information about Hatch Act training? (this is not required for the 2302(c) program): Yes ______ No ______

Revised: 12/16/08