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Dean of Students Office Intake Form


This form is for students wanting to connect with the Dean of Students. The information entered will assist the staff within the office in supporting and responding to the needs of the student.

If this is a CARE Team matter, please use the specific CARE Team reporting form: CARE Team Referral

If this is a report of Sexual Violence, please use the specific Sexual Violence reporting form: Sexual Violence Report

This form is not monitored 24 hours a day and does not notify first responders. Please call 911 or MSUM Public Safety at 218-477-2449 if you are experiencing an emergency.

General Information

 
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Personal Information

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Questions

What brings you to the Dean of Students Office today?(Required)
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What is the best way to contact you?(Required)
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If we call you, can we leave a message?(Required)
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Please indicate if you have recently connected or are working with one of the following:
You must make at least one selection.

Supporting Documentation

For Student Bereavement Policy: please provide a PDF of the obituary. If leave is related to a reason other than Student Bereavement, please provide documentation (i.e., note from doctor, jury summons, note from student organization advisor). 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission