Ethics Portal Form: Add

First Name of Person Making Complaint:

Last Name of Complainant:

Employer of Complainant:

Position/Title of Complainant:

Complainant Street Address:

Complainant City:

Complainant State:

Complaintant ZIP:

Email Address of Complainant:

Phone Number of Complainant:

Name of individual or organization reported to be in violation of the Code (“Respondent”):

Employer of Respondent, if applicable:

Email address of Respondent, if known:

Which Code of Conduct item(s) does the infraction violate?|The five key ethics guidelines are broken into several questions. Please select the most appropriate item(s) that apply to this report.

1. No action will be taken by financial aid staff that is for their personal benefit or could be perceived to be a conflict of interest:

2. Information provided by the financial aid office is accurate, unbiased, and does not reflect preference arising from actual or potential personal gain:

3. Institutional award notifications and/or other institutionally provided materials shall include the following:

4. All required consumer information is displayed in a prominent location on the institutional web site(s) and in any printed materials, easily identified and found, and labeled as “Consumer Information.”:

5. Financial aid professionals will disclose to their institution any involvement, interest in, or potential conflict of interest with any entity with which the institution has a business relationship.:

Did this infraction occur within the last 12 months?:

Description of Code violation (provide as much detail as possible):

Upload any files or documents you would like considered as evidence. |File format options include .pdf, .doc, .docx, .xls, .xlsx, .jpg, .gif, .png

File Upload File One:

File Upload File Two:

File Upload File Three:

File Upload File Four:

File Upload File Five:

Signature:

‘I attest that all information is correct and truthful to my knowledge. I agree to cooperate in the Code of Conduct enforcement process. I understand that, upon request by the Ethics Commission, I may or may not be asked to provide testimony in the presence of the member against whom the complaint is lodged. I understand that my failure to cooperate in the investigation or hearing may be considered by the Ethics Commission or the hearing panel as grounds to dismiss the complaint. I understand that if I withdraw my complaint, NASFAA may still proceed with an investigation if deemed necessary. I understand that NASFAA may, in its discretion, defer any action on a complaint if a legal proceeding has commenced or is pending with regard to the subject matter of a complaint, or for other pressing circumstances. NASFAA may also, in its discretion, refer matters to federal, state, or local government agencies in appropriate situations.’