Dean of Students Internal Conduct Check Request Form

This form should be used by a UTA office or department that is seeking a disciplinary conduct check for a student or group of students. Such disciplinary checks should be requested to determine a student's eligibility to participate in a UTA program, event, or activity.

Division or Department Name:
Submitter's Name: Submitter's Name: First Last
Submitter's Job Title:
Submitter's Email:
When is this conduct check needed by?
All submissions must be made at least one week in advance. When is this conduct check needed by?
All submissions must be made at least one week in advance. / MM / DD YYYY
Please state the purpose or reason for seeking this conduct check. Why is it being requested?
Student ID Submission

Student ID numbers must be submitted using the Dean of Students Internal Conduct Check Request spreadsheet.

The blank submission spreadsheet can be found on the Forms page of the Office of the Dean of Students website or at the following link: https://cms.prod.web.uta.edu/-/media/project/website/student-affairs/dos/forms/student-id-submission-sheet.xlsx

Once completed, please upload the spreadsheet containing all student ID numbers below.
Upload a File

Attach Files
Conduct Check Affirmations
Submitter affirms that all students included in this request have given their permission to have their conduct records reviewed, either through an application process or by signing a release form. Submitter affirms that the information provided by this conduct check will only be used for the purpose listed on this Form. Submitter affirms that the information provided by this conduct check will be maintained with the application or release which authorized this check. Submitter affirms that the information provided by this check is maintained and accessible exclusively by the appropriate assigned staff member in your Division or Department.
Conduct Check Reminders

Please note that only reportable disciplinary conduct records are shared through this internal conduct check process. Generally, this includes sanctions of disciplinary probation within the past seven (7) years, and all suspensions and expulsions. If you need information about other disciplinary outcomes, please email Community Standards in the Office of the Dean of Students at conduct@uta.edu.

Dean of Students Internal Conduct Check Request Form

Student ID Submission

Conduct Check Affirmations

Conduct Check Reminders