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Human Resources
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Home Human Resources Benefits About Our Benefits Program Domestic Partner Benefits Declaration of Termination of Domestic Partnership

Declaration of Termination of Domestic Partnership

Please fill out the form below, or print the form and return it to the Office of Human Resources.

About Our Benefits Program
Health, Dental, and Voluntary Vision Benefits
Life Insurance
Disability Benefits
Retirement Savings Plan
Other Benefits and Perks

Contact Information

Benefits Administration and Enrollment:
Kim Austin
(540) 458-8921
Retiree Counseling:
Jason Bunn
(540) 458-8923

Mailing Address:
Human Resources
204 W. Washington Street
Washington and Lee University
Lexington, Virginia 24450
(540) 458-8920
Fax: (540) 458-8060
Physical Address:
2 S Main Street
Lexington, VA 24450

Washington and Lee University

204 W. Washington St. Lexington VA 24450 540-458-8400

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In compliance with Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, and all other applicable non-discrimination laws, Washington and Lee University does not discriminate on the basis of race, color, religion, national or ethnic origin, sex, gender identity, gender expression, sexual orientation, age, disability, veteran's status, or genetic information in its educational programs and activities, admissions, and with regard to employment. Inquiries may be directed to the Title IX Coordinator, Elrod University Commons 212, (540) 458-4055, who is designated by the University to coordinate compliance efforts and carry out its responsibilities under Title IX, as well as those under Section 504 and other applicable non-discrimination laws. Inquiries may also be directed to the Assistant Secretary for Civil Rights, U.S. Department of Education. See Non Discrimination Statement

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