Formal Complaint Form

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

Formal Complaint Form (Title IX Sexual Harassment)

Instructions for filling out this form: If you believe that you have been the victim of sexual harassment, please fill out this form, sign where indicated below, and submit it using the "Submit Formal Complaint Form" button listed below. You can also print off the form and submit it by hand delivery, electronic mail, or U.S.mail using the contact information listed for the Title IX Coordinator at Marshall University: Title IX Office, Old Main 107, Huntington, WV 25755 or titleix@marshall.edu. This formal complaint form is intended for use by the alleged victim of Title IX sexual harassment (referred to in Title IX Regulations as the “Complainant”). Under Title IX and the Family Educational Rights and Privacy Act (FERPA), a parent or legal guardian may sign a complaint form and otherwise act on behalf of a minor in the formal complaint process. If you are not filling this form out as a parent or guardian and you intend to report sexual harassment against another person in the University’s education program or activities, please report your concerns to the University’s Title IX Coordinator so that the University can take further action. Under federal law, only an alleged victim of sexual harassment who is currently participating or attempting to participate in the University’s education program or activity (such as an enrolled student, an employee, or an applicant for employment or admission) has the right to use the formal complaint process to initiate an investigation. The University will process all formal complaints in accordance with Title IX Procedures.

Name of Complainant(Required)

First Last

Email address of Complainant(Required)

Enter Email Confirm Email

Address of Complainant(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Telephone number of Complainant(Required)

Is the Complainant participating in or attempting to participate in a University education program or activity?(Required)

If you are a parent or guardian filling this form out on behalf of a minor Complainant, please provide your name below.

First Last

If you are a parent or guardian filling this form out on behalf of a minor Complainant, please provide your address below.

Street Address Address Line 2 City State ZIP Code

You have the right to be represented by an advisor during the complaint process. The advisor may be an attorney, but it does not have to be. If an attorney or other advisor will represent you in presenting your complaint, please identify the person below. If the person is unknown at this time, you may provide this information at a later time.

First Last

If an attorney or other advisor will represent you in presenting your complaint, please provide the contact information below.

Street Address Address Line 2 City State ZIP Code

Please list any additional individuals you intend to bring with you to any meetings or interviews associated with this complaint and provide their contact information below. You can attach a word document at the end of this form if necessary and indicate if you are doing such below.

Please provide a detailed account of the facts and circumstances surrounding the alleged sexual harassment related to this complaint. Include specific, factual details. If necessary, you may attach a Word document at the end of this form and indicate that you are doing so below.(Required)

In a Title IX formal complaint process, the person who is alleged to have committed the sexual harassment is called the “Respondent.” Please provide the name(s) of the person or people you allege to be the Respondent(s) responsible for the alleged sexual harassment. :(Required)

First Last

Respondent's title or position if applicable:

When and where did the alleged sexual harassment occur? Please provide specific dates, times, and locations, if possible.(Required)

Please explain how the alleged sexual harassment has impacted you. This could include physical injuries as well as impacts on your ability to access or benefit from the University’s education program or activities. If necessary, you may attach a Word document at the end of this form and indicate that you are doing so below.(Required)

Please provide the names and contact information of anyone who may have witnessed the alleged conduct. You can provide this information at a later time.

If you have reported these allegations to another person, please state to whom you reported the alleged sexual harassment and provide their contact information (if known).

Title IX does not require Complainants to attempt to resolve sexual harassment complaints informally before filing a formal complaint. Nonetheless, if you have reported these allegations to a University employee, please state when to whom, and what response you received.

Please list below any evidence that you believe is relevant to your allegations. This could include audio or visual media, physical objects, online materials, text messages, voicemail messages, screen captures, emails, or any other item you are attaching or intend to make available for the purpose of this complaint. If known, please also identify any information in the University’s possession that you believe to be relevant to your allegations and would like the University to review (such as emails or security camera footage). You may also state "No Evidence" if that is appropriate.(Required)

Please provide any other information that would be helpful for the University in reviewing your allegations.

Please describe the outcome or remedy you seek for this complaint(Required)

Upload Any Additional Document

Upload your document in .pdf, .doc or .docx format

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

Please provide your digital signature below.(Required)

Complainant First Name Complainant Last Name

If Complainant is under 18, parent's or guardian's digital signature below.

Parent or Guardian First Name Parent or Guardian Last Name

If this formal complaint is being signed by Marshall’s Title IX Coordinator instead of a Complainant:

Title IX Coordinator First Name Title IX Coordinator Last Name

Verification of Electronic Signature(Required)

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

Notice to Complainant: This document is a legal record of the allegations of sexual harassment that you have reported to Marshall University to request a formal investigation. Please keep a copy of this completed form and any supporting documentation for your records. Please also review your rights and responsibilities, which are available online at Complainant Resources.

If you have any questions or concerns about this process, please email Marshall’s Title IX Coordinator at titleix@marshall.edu. If, after reviewing your complaint form, the Title IX Coordinator finds that the allegations are not appropriate for a Title IX sexual harassment formal complaint process but should be investigated by the University under a different policy or procedure, your formal complaint form will be forwarded to the appropriate University personnel in accordance with University policies. You have the right to appeal the dismissal of your formal complaint, as explained in Marshall Title IX Procedures.

Formal Complaint Form

Formal Complaint Form (Title IX Sexual Harassment)

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