Withdrawal of the Formal Complaint Form

This is the Withdrawal of the Formal Complaint Form to be submitted to be considered by the Title IX Office.

Withdrawal of the Formal Complaint Form (Title IX Sexual Harassment)

Instructions for filling out this form: Please provide your full name, student identification number, and email address as well as the name of the individual against whom the complaint was filed. You may state the reason(s) for withdrawing your formal complaint in the Reason for Withdrawal section, but that is not required. Read the acknowledgment statement carefully, sign your name in the provided space, and enter the date when you are signing the form. If you have any questions or need assistance while filling out the form, please do not hesitate to reach out to the Title IX office.

Name of Complainant(Required)

First Last

Student ID of Complainant(Required)

Student ID Confirm Student ID

Email address of Complainant(Required)

Enter Email Confirm Email

Name of Respondent(Required)

First Name of Respondent Last Name of Respondent

Reason for Withdrawal

Upload Any Additional Document

Upload your document in .pdf, .doc or .docx format. To upload, click on "Choose File" to access your documents and choose the file you wish to upload. "Choose File" may not appear to be a link, but it is.

Accepted file types: pdf, doc, docx, Max. file size: 25 MB.

Acknowledgment: I hereby notify the Title IX Coordinator that I wish to withdraw my formal complaint or specific allegations therein. I understand that the withdrawal of my complaint may result in the dismissal of the investigation related to this complaint.(Required)

Complainant First Name Complainant Last Name

Verification of Electronic Signature(Required)

I verify that I am the person signing this Withdrawal of the Formal Complaint Form and it is my name listed above.

Once you have completed the form, the form will be submitted to the Title IX Coordinator for processing.

If you have any questions or need assistance while filling out the form, please do not hesitate to reach out to the Title IX office.