Witness Request Form

Student Information

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Your name:

Your student ID number:

Your phone number:

Your email address:

Email address must be of a valid format.

First Hand Witness Information

The respondent/complainant each may request anyone with first hand knowledge of the incident attend the student conduct hearing. You are not required to request first hand knowledge witnesses.

If a first hand witness is unable to attend the scheduled hearing, s/he may fill out a written statement with the Department of Safety & Security. Written statements filled out with Safety & Security will be used in the hearing process. Written statements MUST be filled out at least 48 hours before the scheduled hearing.

Witness #1 Name This field is required.

Witness #1 Phone Number This field is required.

Witness #1 Email This field is required.

Role of the Witness #1 in this incident This field is required.

Witness #2 Name This field is required.

Witness #2 Phone Number This field is required.

Witness #2 Email This field is required.

Role of Witness #2 in this incident This field is required.

Witness #3 Name This field is required.

Witness #3 Phone Number This field is required.

Witness #3 Email This field is required.

Role of Witness #3 in this incident This field is required.

Email me a copy of this report

Student Information

First Hand Witness Information

Submission