UAA Title IX Training - Release Request

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University of Alaska Anchorage is committed to providing a supportive learning and working environment and fostering safe, healthy relationships online and on campus. As such, the institution and members of our community will not tolerate the offenses of sexual harassment, gender-based discrimination, sexual assault, dating and domestic violence, and stalking. This training is intended to help you learn more about these issues as you hold an important role in keeping our campuses and classrooms respectful and safe.

The University of Alaska recognizes that some who may take this training have experienced violence/victimization. This survey contains language about sexual acts and violence.

Your well-being is paramount. In the event you are unable to complete this training due to personal experiences, please complete this brief request to be released from the training which will be submitted directly to your Title IX Coordinator. The identifying information you provide will be kept confidential.

Please enter your first and last name as they appear in University records

First Name *

Last Name *

Please enter your 8-digit University ID number

ID Number *

Please indicate your primary University affiliation, student or employee? *

Student

Employee

Please enter your University provided email address

Email address *

We can help

If you have been sexually harassed, assaulted or threatened, the university has ways to
help you, including but not limited to:

• Providing access to counseling services
• Providing access to confidential advocacy services
• Rescheduling of exams and assignments
• Changing class schedules
• Providing access to academic advising
• Changing university work schedule or job assignment
• Changing campus housing
• Providing access to medical services
• Implementing a no contact order

Requests for assistance must be submitted to your Title IX Coordinator. Contact information and more resources can be found at www.alaska.edu/equity.

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