Forms and Resources

Appeals

Students may appeal a student conduct outcome within five business days from the date the student is informed of the original decision. The appeal must be submitted using the Student Conduct Appeal Form to the vice president of student life (or designee). Students shall be advised in writing of the decision on the appeal within 14 business days.

Student Conduct Appeal Form

Student Records Release

The Family Rights and Privacy Act of 1974 (FERPA) provides for the confidentiality of student educational records. Fairfield University may not disclose information in a student's educational record to anyone, without the permission of the student, unless disclosure is permitted by an exception set forth in FERPA, 20 U.S.C.A., Sec. 1232 et seq.

If a student would like to grant permission to Fairfield University officials to disclose and/or discuss contents contained in education records at Fairfield University they must complete and sign a release.

FERPA Release Academic

FERPA Release Dean of Students

Confidential Reporting Form

If you know of a potential crime that has occurred on campus, please report it. This system is monitored Monday through Friday from 8:30 a.m. to 4:30 p.m.

For immediate service, call (203) 254-4090 or ext. 4090 - all phone calls can remain anonymous.

Public Safety Confidential Reporting Form

Reporting

Please use this forms to report alleged violations of the Student Conduct Code or other University policies.

*For Residence Life staff only.

General Incident Reporting Form

Off-Campus Concern Report

*Residence Life Incident Reporting Form

Death Notification

In the event of a death, please fax form to the Office of the Dean of Students at ext. 4014.

Information Form for Death Notification 

Requesting Readmission

Students requesting readmission following a medical withdrawal from Fairfield must complete a Post-Medical Withdrawal Readmission form.

Post Medical Withdrawal Readmission Form

Student Support and Relief Fund

Fairfield University is committed to providing support to our students who are facing unexpected financial burdens. The Student Support and Relief Fund is a need-based fund administered by the Office of the Dean of Students in consultation with the Office of Financial Aid. Funding is available to all currently enrolled Fairfield University students and who meet the eligibility criteria.

Submit Student Support and Relief Fund Form

Dean's Certification

Please complete the applicant information section and submit this form to the Dean of Students at each institution you have attended. Your signature authorizes the release of information regarding your disciplinary record.

Certification Form PDF

Requesting a Withdrawal

Voluntary Withdrawal

Students applying for a voluntary withdrawal (for non-medical reasons) must contact their appropriate Academic Dean's Office in writing and set up a meeting to facilitate the withdrawal process and to discuss any future plans to return to the University. The institutional refund policy applies.

• College of Arts and Sciences, CNS 100, ext. 2221

• Academic and Career Development, Kelley Center, ext. 2222

• Dolan School of Business, DSB 1125, ext. 3230

• Egan School of Nursing & Health Studies, Egan School 102, ext. 4150

• School of Engineering, BNW 167, ext. 4147

Medical Withdrawal

Students who wish to withdraw from Fairfield University for medical reasons may request and be considered for a medical withdrawal when extraordinary circumstances prevent that student from continuing with classes. Medical withdrawals cover both physical as well as mental health difficulties. Students are expected to remain away for at least a full semester (fall or spring) after a medical withdrawal before seeking readmission, unless deemed otherwise by the director of the Student Health Center or Counseling & Psychological Services. The institutional refund policy applies. All withdrawal policies are found in the Academic Course Catalogs.

To discuss withdrawing as a student for medical reasons, contact the Student Health Center (203) 254-4000, ext. 2241, Counseling & Psychological Services (203) 254-4000 ext. 2146, or the Office of the Dean of Students (203) 254-4211.