Expungement Request Form

Name * Required
First Last
UIN * Required
Address * Required
Street Address Address Line 2 City State ZIP Code
Phone Number * Required
Email * Required
Date of Student Life Conduct Conference * Required
MM slash DD slash YYYY
Have you Graduated? * Required
- Yes
- No
Graduation Date * Required
MM slash DD slash YYYY
Anticipated Graduation Date * Required
MM slash DD slash YYYY
Corps of Cadets Status * Required
- Yes
- No
Were you a member of the Corps of Cadets at the time of the incident that resulted in a conduct file?
Incident(s) * Required
Please provide a summary of why you have a student conduct record. If there were multiple incidents, please provide information on all applicable situations.
Sanction(s) * Required
Please list the sanction(s) that you were assigned as a result of the incident(s) referenced above.
Basis for Expungement Request * Required
Please provide a statement of the basis for your expungement request. This statement should include: * The rationale for the request * What, if any, impact the behavior at the time of the incident(s) had on the University community * In what ways, if any, your behavior has changed since the incident(s) * What, if anything, you have learned from the incidents and/or the student conduct process (Complainants who only have a complainant file only need to provide the rationale for the request)
Comments
This field is for validation purposes and should be left unchanged.

Division of Student Affairs