POINT PARK UNIVERSITY

Student-Athlete Serious Misconduct Attestation Form

Point Park University is committed to sexual violence prevention. Sexual discrimination, sexual harassment, and sexual and interpersonal violence violate human decency and the University’s core values.

Please disclose whether or not you have been disciplined through or named a respondent in a Title IX, student conduct, or sexual misconduct proceeding or whether or not you have been criminally convicted, regardless of degree or whether or not it was the result of a plea or other court determination of any of the following:

Sexual Violence: A term used to include both forcible and nonforcible sex offenses, ranging from sexual battery to rape.
Interpersonal Violence: Violence that is predominantly caused due to the relationship between the victim and the perpetrator, including dating and domestic violence.
Other Acts of Violence: Crimes including murder, manslaughter, aggravated assault, or any assault that employs the use of a deadly weapon or causes serious bodily injury.
Other Forms of Serious Misconduct: Crimes including felony drug possession/distribution, felony theft, or multiple DUI’s/DWI’s.

ATTESTATION:

I attest that I HAVE NOT been found responsible for violating a high school, College, or University policy or been subject to discipline through a Title IX, student conduct or sexual misconduct proceeding or criminally convicted for sexual violence, interpersonal violence, or any other act of violence as described above, AND that I did not leave any prior institution with conduct charges PENDING for such acts.I attest that I HAVE been found responsible for violating a high school, College, or University policy; or been subject to discipline through a Title IX, student conduct or sexual misconduct Proceeding; or criminally convicted for sexual violence, interpersonal violence, other acts of violence, or serious misconduct as described above OR HAVE PENDING charges through a Title IX or sexual misconduct proceeding.

Was or will the Title IX, student conduct or sexual misconduct proceeding be complete or pending at the time of your attendance at Point Park University.

CompletePending

Institution Name:

I agree to allow Point Park University through oversight of the Title IX Office and with assistance of the Vice President of Athletics or the Assistant Director of Athletics for Compliance where applicable, to contact the above institution to gather additional information regarding disclosure.

[NOTE: If the criminal adjudication or conviction has been expunged, sealed, annulled, pardoned, destroyed, erased, impounded, or otherwise required by law or ordered by a court to be kept confidential you are not required to answer “yes” to these questions or provide an explanation.]

By entering your name below you are signing this form electronically and agreeing: I attest that, to the best of my knowledge and belief, that all information attested to on this form is accurate and complete, and that providing purposefully false information on this form could result in penalties by Point Park University and/or the NCAA, including jeopardizing my eligibility and/or scholarship receipt. A criminal or disciplinary history is not an automatic disqualifier for admission, though it may lead to conditions or set expectations for an applicant or student that will enhance the safety of the institutional community.

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