Respondent Information Form - Msu Office Of Instutional Equity (Page 3 of 3) in pdf

Respondent Information Form - Msu Office Of Instutional Equity Page 3

RESPONDENT INFORMATION FORM

MSU OFFICE OF INSTUTIONAL EQUITY

REASONABLE ACCOMMODATION

If you are an individual with a disability and need accommodation to fully participate in the complaint, investigation, or student

conduct process, please contact the Resource Center for Persons with Disabilities at (517) 884-7273.

RESPONDENT AFFIRMATION

I affirm that I have received the OIE Respondent Information Form, the MSU Relationship Violence and Sexual Misconduct Policy,

and the Resource Guide.

______________________________________

_____________________________

Signature

Date

____________________________________

Printed

OIE USE ONLY

Interim Measures Implemented: ______________________________________________________________________________

_________________________________________________________________________________________________________

No Contact Directives Implemented: __________________________________________________________________________

_________________________________________________________________________________________________________

OIE Staff Member: ______________________________________________________

Date: ________________________

Office of Institutional Equity

4 Olds Hall

East Lansing, MI 48824

Revised 7/27/2017

Phone: (517) 353-3922

Respondent Information Form - Msu Office Of Instutional Equity Page 3