FORM-Consent to Disclose

Advisor Information Form

Office of Student Conduct

The Office of Student Conduct will provide this form to all students prior to their disciplinary hearings. If the student chooses to have an advisor, this form should be filled out and provided to the Office of Student Conduct. All advisors must be a WVU faculty, staff, or student except in cases involving BOG Rule 1.6 violations.

Required Information

Advisor Name:

Title:

Address:

Email:

Phone(s):

Office
Cell
Other

Student Advising:

Pursuant to Section 9.10 of the Student Conduct Code, the respondent and any other student participating in the process may have an advisor accompany them to a hearing for charges seeking suspension or expulsion. The advisor may be an individual that is either a member of the faculty, staff, or a student at West Virginia Unversity. Advisors may participate in the proceedings consistent with the Hearing Adjudicators instructions.

Confidentiality Acknowledgement

By serving as an advisor, you will be privy to confidential materials/information that contain personally identifiable student information. The confidentiality of the process and the student names in the file must be protected.

I understand that the materials/information provided to me by the Office of Student Conduct at West Virginia University are protected by the Family Educational Rights and Privacy Act (FERPA). I agree not to share them with any person not authorized to review them unless otherwise permitted by law. I agree that should I feel the necessity to disclose personally identifiable information about a student, I will contact the Office of Student Conduct which will make reasonable and timely efforts to obtain consent of the student.

Signature of this document signifies your acknowledgement of these expectations.

With my signature below, I certify that my statements are accurate.

Signature:

Sign Here

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I am unable to sign the field above and require a disability-related reasonable accommodation. By typing my full name below, I certify that my statements are accurate.

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Date: March 28, 2025