Advisor Designation and Authorization Forms

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Advisor Designation and Authorization Forms

Advisor Designation and Authorization Forms

Name ______

Student ID Number ______

Pursuant to Paragraph 15 of the University of Oregon’s Student Conduct Standard Operating Procedures Regarding Sexual Misconduct, Sexual Harassment, and Unwanted Sexual Contact, I hereby designate ______to serve as my advisor in the student conduct process. I understand that I may change advisors during the process, and that to do so I must submit a new Advisor Designation form. I also acknowledge that only one advisor may be present during any particular meeting or proceeding that is part of this process.

 I have been advised that if the decision-maker in the student conduct process determines that my advisor has engaged in unreasonable, disruptive, harassing or retaliatory behavior, the decision-maker may require that I proceed without an advisor or may require me to identify a new advisor.

 By my signature below, I give my voluntary consent for the Office of Affirmative Action and Equal Opportunity to disclose all Title IX Investigation records and information related to me to the individual designated as my advisor.

 I authorize University of Oregon officials to orally discuss information contained in my Title IX Investigation records with the individual designated as my advisor.

 I authorize University of Oregon officials to release all Title IX Investigation records and information related to me to my advisor upon his or her request.

 I understand that under the Federal Education Rights and Privacy Act of 1974, no disclosure of my records can be made without my written consent unless otherwise provided for, in legal statutes and judicial decisions. I also understand that I may revoke this consent at any time except to the extent that action has already been taken upon this release.

 As part of this designation I would like for you to copy my advisor on all communications that are directed to me during this process. Initial here ______

This Advisor Designation and Authorization form revokes all previous Advisor Designation and Authorization forms, and also revokes all prior FERPA releases that I provided to the Office of Affirmative Action and Equal Opportunity.

______(Signature of Student) (Date) CONSENT TO DISCLOSE STUDENT RECORDS MAINTAINED AT THE UNIVERSITY OF OREGON DURING THE SEXUAL MISCONDUCT STUDENT CONDUCT PROCESS

In cases of sexual misconduct, University Officials, including the Title IX Coordinator, Office of Student Conduct, Office of the Dean of Students, and Office of Affirmative Action and Equal Opportunity may maintain records personally identifiable to you that are generally protected from disclosure outside the University, pursuant to the Family Educational Rights and Privacy Act of 1974 (“FERPA”). This release represents your written consent to disclose responsive education records, otherwise protected by FERPA, maintained by these and other University of Oregon offices to the specific individual(s) you identify below.

Please read this document carefully, fill in all the blanks, and indicate or describe what specific information may be disclosed.

I, ______(Print Full Name) (Student ID Number)

AM / WAS a student at the University of Oregon and hereby give my voluntary consent to University Officials orally discussing the information contained in my educational records. The information to be released is:

 Student conduct investigation and conduct process records and information relating to the investigation and process  Other – specified here:

To the following person(s):  Chosen Advisor: ______ Parent(s):______ EPD Detective:______ Deputy District Attorney:______ Other Individual(s):______

These records are being released for the purpose of:

[Indicate the purpose of the disclosure; i.e., communication with parents, attorney, facilitating law enforcement proceeding etc.]

I understand that under FERPA, and absent applicable legal exceptions, no disclosure of my education records can be made outside the University or to School Officials who do not have a legitimate educational interest in the records, without first obtaining my signed, written consent. I also understand that I may revoke this consent at any time via handwritten notice; however, any such revocation will apply prospectively and not apply to action that has already been taken in reliance on this release.

(Signature of Student) (Date) NOTE: If you would like records from other locations on campus, i.e., academic, health, counseling or other records, to be produced to the persons identified above, you must separately contact the department responsible for maintaining those records to obtain the applicable release form.

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