Academic Integrity Report Form

Background Information

This incident report is for academic misconduct reporting only. Your action in the classroom is the first step. Additional behavioral sanctions may be imposed by Student Affairs Office for a repeat offender. Please contact the Office of Student Affairs (Teresa Clounch, Ed.D.), 785.628.4664, if you have any questions.

Enable additional features by logging in.

Your full name:

Your position/title:

Your phone number:

Your email address:

Email address must be of a valid format.

Your physical address:

Nature of this report(Required):

This field is required.

Urgency of Report(Required):

This field is required.

Date incident occurred(Required):

This field is required.

Location of incident(Required):

This field is required.

Involved Parties

Name or Organization

Select Gender

Email address

Questions

Describe communication you have had with the student regarding the academic integrity concern.(Required) This field is required.

What academic sanction was imposed for student(s) involved?(Required)

Warning U for class U for assignment Lower grade on assignment Lower grade in course Withdrawn from course I will not impose sanctions at this time

You must make at least one selection.

Description or Narrative Please provide a detailed description of the incident using specific, concise, objective language. Please refrain from using pronouns (he, she, etc.) to refer to people in the body of the report. Be sure to document specific language and behaviors rather than your opinions or judgments about the person's language and behaviors.(Required) This field is required.

Further action you would like to see for this student(Required) This field is required.

Supporting Documentation

Photos, videos, email, and other supporting documents may be attached below. Maximum 12 megabytes per file. Attachments require time to upload, so please be patient after you click to submit this report. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Email me a copy of this report

Background Information

Involved Parties

Questions

Supporting Documentation

Submission