Interim Measure Appeal FormHome / Conduct Process / Appeals / Interim Measure Appeal Form Conduct Process University Policies Code of Student Conduct Drug and Alcohol Policies Sexual and Gender-Based Misconduct and Other Forms of Interpersonal Violence Other University Resources Case Resolution Process Sexual and Gender-Based Misconduct and Other Forms of Interpersonal Violence Medical Amnesty Program Appeals Student Conduct Appeal Form Policy 1202 Appeal Form Interim Measure Appeal Form If you have been placed on an interim status prior to a hearing (i.e. interim suspension), you may submit an appeal. Interim Measures Please enter your information below. For a student organization include the name of the organization and not the individual (i.e. the President). For a student organization please enter 00000000 as the G Number. Do not add another person or student organization to your appeal.Name First Last G Number (numbers only)Student Organization Email* Date of Interim Measure* MM slash DD slash YYYY Issuing Department* Compliance, Ethics and Diversity Housing and Residence Life Office of Student Conduct Other Type of Interim Measure* Interim Suspension: Suspending a student or student organization on an interim basis. Interim No Contact Order: Imposing a no contact order between a student and another person or persons, on an interim basis. Interim Housing Suspension: Suspending a student from any or all residential communities. Administrative Trespass Order: Issuing an administrative trespass order from specific buildings, or from the entire campus. Interim Schedule Change: Alteration of academic or work schedules. Other Please enter the rationale for submitting your appeal.Supporting DocumentationPlease submit all relevant information to be considered in your appeal. Attachments require time to upload, so please be patient after submitting this form. Limit of eight (8) megabytes permitted. Drop files here or Select files Accepted file types: pdf, doc, docx, Max. file size: 50 MB.
