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Academic Dishonesty Report Form - Student Conduct


If you need to report an emergency, please call University Police at 805-437-8444, or dial 911



The Dean of Students office at CSU Channel Islands is charged with upholding the Student Conduct Code, which identifies behavioral expectations for all students on and off campus. If you have knowledge of a CI student violating the Student Conduct Code, you are encouraged to notify our office of the incident.

Please use this form to report any acts of academic dishonesty, including cheating/plagiarism as outlined in the Student Conduct Code. Once you submit the form it will be reviewed and you may be contacted for additional information.

To make a report of non-academic behavior, please use the Student Conduct Incident Report form found here: Student Conduct Reporting Form

If you would like to report an incident of discrimination, harassment (including sexual harassment, sexual misconduct, and/or gender based dating and domestic violence or stalking), or retaliation please submit a report here: Referral to Title IX & Inclusion Office

If you have any questions regarding filing an incident report, please contact the Dean of Students office at 805-437-8512.

Background Information

 
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Academic Dishonesty Report
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example: Biology 101

Involved Parties

Please complete the information below and include as many individuals involved with the act of academic dishonesty.

Involved party 1

Questions About the Incident

This information assists the staff member(s) of the Dean of Students office to prepare for the associated meeting(s) with the student(s). We appreciate your time in completing the below section.

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2. Has the Program Chair been informed of this incident?(Required)
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3. What actions have already been taken by the faculty member?(Required)
You must make at least one selection.
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4. Have you met or spoke with the student regarding this incident?(Required)
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5. Is this the first time the student has exhibited academic dishonesty in your class? If not, please answer the questions below.(Required)
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6. Does your syllabus contain language about Academic Dishonesty?(Required)
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7. Did you inform the student that this incident would be reported to the Dean of Students office (this is highly recommended)?(Required)
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Did this student receive an F in the course as a result of the alleged behavior? (Course failure due to academic dishonesty prevents the student from being eligible for grade forgiveness. This information will be reported to the Registrar.)(Required)
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Supporting Documentation

Please submit a copy of the assignment/exam/paper that supports the allegation. Additionally, it is recommended that you submit a copy of your syllabus and any supporting evidence (i.e. sources student plagiarized from). 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission