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Pregnant and Parenting Supportive Measures Request Form


The University of North Carolina at Pembroke is committed to creating and maintaining a community where all individuals enjoy freedom from discrimination, including discrimination on the basis of sex, as mandated by Title IX of the Education Amendments of 1972 (Title IX). Title IX prohibits discrimination - including discrimination on the basis of pregnancy, adoption, guardianship, parenting, and all related conditions - in education and in programs and activities that receive federal funding. If you are a pregnant or parenting student, you have the right to stay in school so you can meet your education and career goals.

Please be advised that to receive Supportive Measures for pregnancy and parenting issues, medical or other documentation will need to be submitted to the Title IX Coordinator. You may use this form or other means to provide this information (email, fax, hand-delivery, mail). The documentation can be submitted to the Office of Title IX and Clery Compliance via the following methods:

Email: titleixcoordinator@uncp.edu

Fax number 910-521-6178

University address:
Post Office Box 1510
Health Services Building, Room 337
Pembroke, North Carolina 28372

Request Information

 
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Involved Parties: Parents of child

Involved party 1

Questions

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Supporting Documentation

You may attach any medical or supplemental documentation here OR email, mail, or drop off documentations as outlined in this forms instructions. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

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