Formal Complaint Form

Formal Complaint Form (Title IX Sexual Harassment)

This form is to be submitted to the Title IX Office to initiate a formal complaint of sexual harassment under Title IX. Instructions: If you believe you have experienced sexual harassment, please complete this form, sign it, and submit it using the “Submit Formal Complaint Form” button below. You may also print and submit the form via hand delivery, email, or U.S. mail using the contact information provided: Title IX Office Old Main 107 Marshall University Huntington, WV 25755 📧 titleix@marshall.edu This form is intended for use by the individual who experienced the alleged sexual harassment (referred to as the “Complainant” under Title IX regulations). Under Title IX and the Family Educational Rights and Privacy Act (FERPA), a parent or legal guardian may complete and sign this form on behalf of a minor. If you are not the Complainant and wish to report sexual harassment involving another individual, please contact the Title IX Coordinator directly. Only individuals who are currently participating in or attempting to participate in the University’s education programs or activities (e.g., students, employees, applicants) may initiate a formal complaint under Title IX. All formal complaints will be processed in accordance with Marshall University’s Title IX Procedures.

Formal Complaint Form (Title IX Sexual Harassment)

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)

Are you currently participating in or attempting to participate in a University education program or activity?(Required)

If submitting on behalf of a minor Complainant:

Parent/Guardian First Name Parent/Guardian Last Name

Parent/Guardian Address:

Street Address Address Line 2 City State ZIP Code

Advisor Information (Optional):

You have the right to be accompanied by an advisor throughout the complaint process. The advisor may be an attorney or another individual of your choosing. If you have not yet identified an advisor, you may leave this section blank and provide the information later. If you do not select an advisor, the Title IX Office will assign one to you.

Advisor First Name Advisor Last Name

Advisor Contact Information:

Street Address Address Line 2 City State ZIP Code

Additional Participants (Optional):

Please list any individuals you intend to bring to meetings or interviews, along with their contact information. You may attach a separate document if needed.

Detailed Account of the Alleged Sexual Harassment:(Required)

Include specific facts, dates, times, and locations. You may attach a Word document if needed.

Identify the Individual Accused of Sexual Harassment (Respondent):(Required)

Respondent First Name Respondent Last Name

Respondent's Title/Position (if applicable)

Date(s), Time(s), and Location(s) of Incident(s):(Required)

Impact on You:(Required)

Describe any physical, emotional, or educational impacts. You may attach a Word document if needed.

Witnesses:

Provide names and contact information, if known. This can be submitted later.

If you have previously reported these allegations to another individual, please provide their name and contact information (if known).

While Title IX does not require Complainants to pursue informal resolution before filing a formal complaint, if you have previously reported these allegations to a University employee, please indicate to whom you reported them, when the report was made, and what response you received.

Please list any evidence you believe is relevant to your allegations.(Required)

This may include, but is not limited to: Audio or video recordings; Photographs or physical objects; Online content (e.g., social media posts, websites); Text messages, emails, or voicemail messages; or Screenshots or screen captures. You may attach these items to this form or indicate your intent to provide them separately. If applicable, please also identify any evidence you believe is in the University’s possession (e.g., emails, security camera footage) that should be reviewed. If you do not have any evidence to submit, you may write “No Evidence.”

Please include any additional information you believe may assist the University in reviewing and assessing your allegations.

Please describe the resolution or outcome you are seeking as a result of this complaint.(Required)

Upload Supporting Documents (Optional):

You may upload any relevant documents to support your complaint. Accepted file types include .pdf, .doc, and .docx. 📎 Maximum file size: 25 MB To upload, click “Choose File” and select the document from your device. (Note: The “Choose File” button may not appear as a link, but it is clickable.)

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

Please enter your digital signature below to confirm the information provided in this complaint.(Required)

Complainant First Name Complainant Last Name

If the Complainant is under 18 years of age, please provide the digital signature of the parent or legal guardian below. (if applicable)

Parent/Guardian First Name Parent/Guardian Last Name

If this formal complaint is being submitted by Marshall University’s Title IX Coordinator on behalf of the Complainant, please provide the Coordinator’s digital signature below. (if applicable)

Title IX Coordinator First Name Title IX Coordinator Last Name

Verification of Electronic Signature(Required)

I confirm that I am the individual signing this Formal Complaint Form and that the name provided above is accurate and belongs to me.

Notice to Complainant: This form serves as a legal record of the sexual harassment allegations you are submitting to Marshall University to request a formal investigation under Title IX. Please retain a copy of the completed form and any supporting documentation for your records. You are encouraged to review your rights and responsibilities, which are available online at Complainant Resources.

If you have questions or concerns about this process, please contact the Title IX Coordinator at titleix@marshall.edu. After reviewing your submission, if the Title IX Coordinator determines that the allegations do not meet the criteria for a Title IX sexual harassment investigation, your complaint may be referred to the appropriate University office for review under a different policy or procedure. You will be notified of this referral, and you retain the right to appeal the dismissal of your formal complaint, as outlined in Marshall University’s Title IX Procedures.

Formal Complaint Form (Title IX Sexual Harassment)

Formal Complaint Form (Title IX Sexual Harassment)

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