Title IX Appeal Extension Request Form

This form is intended for complainants who wish to request an extension of the appeal deadline following the dismissal of a Title IX Formal Complaint. If you were unable to submit your appeal by the original deadline due to extenuating circumstances—such as medical, psychological, or other significant personal challenges—you may use this form to explain your situation and provide supporting documentation. Your request will be reviewed to determine whether an extension is appropriate under the circumstances.

Title IX Appeal Extension Request Form

This form is for individuals who wish to request an extension of the appeal deadline following the dismissal of a Title IX Formal Complaint. Please complete all sections of the form to the best of your ability. Your responses will help the Title IX Office evaluate whether an extension is appropriate based on your circumstances.

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

Name of Respondent(Required)

First Last

Section 1: Explanation for Missing the Original Appeal Deadline(Required)

Describe the circumstances that prevented you from submitting your appeal by the original deadline. Be as specific as you feel comfortable, especially if your delay was due to medical, psychological, or other serious personal reasons.

Section 2: Justification for Why an Extension Should Be Granted(Required)

Explain why you believe an extension is reasonable and necessary. You may include how the delay impacted your ability to participate in the process and why you are now in a position to proceed.

Section 3: Supporting Documentation

Attach any documents you are submitting to support your request (e.g., hospital discharge papers, letters from healthcare providers, etc.). If you are attaching documents, please ensure they are legible and relevant.

Drop files here or

Max. file size: 24 MB, Max. files: 10.

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 Title IX Appeal Extension Request Form and it is my name listed above.

Thank You

Thank you for taking the time to complete this request form. We understand that reaching out and revisiting these experiences can be difficult, and we appreciate your effort in doing so. Please know that your request will be reviewed with care and consideration. If you have any questions or need additional support, don’t hesitate to contact the Title IX Office. You are not alone—we’re here to support you.

Important Reminder: Online Reporting Strongly Preferred

Title IX Reporting - Online Submissions PREFERRED:

The Title IX Office prefers the submission of Title IX report through the online reporting system. It is preferred that all Title IX reports be submitted through our secure online form. This centralized process helps us review reports promptly, triage concerns efficiently, and ensure consistent and equitable responses for our campus community.

In‑person, email, and phone submissions are accepted on a limited basis as reporting methods for Title IX incidents. Those conversations may still occur for support purposes, but they do not constitute an official Title IX report.

Submit an Online Title IX Report

Please note: Due to staff availability, it may take up to five business days for your report to be reviewed.

If You Are in Crisis

Call 911 or contact the Marshall University Counseling Center for immediate support:
Prichard Hall, First Floor
304-696-3111
Marshall University Counseling

We appreciate your understanding and remain committed to supporting a safe, respectful, and inclusive campus environment.