Academic Dishonesty Reporting Form

Background Information

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Your full name:

Your position/title:

Your phone number:

Your email address:

Email address must be of a valid format.

Date of incident(Required):

This field is required.

Campus Location(Required):

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Involved Parties

Please list all individuals involved.

Name or Organization

Eagle ID Number

Incident Information

Subject/Course Prefix(Required) This field is required.

Course #(Required) This field is required.

Please describe the nature of the violation.(Required) This field is required.

Have you already spoken with the student(s) regarding this incident?(Required)

Yes No

This field is required.

If yes, please briefly describe that discussion. This field is required.

If the student accepts responsibility or is found responsible, what would be your recommended academic penalty?(Required) This field is required.

If there is anything else you feel we should know about this incident please provide that information here. This field is required.

Supporting Documentation

Please attach any documents pertinent to the violation (Exams, Essays, Sources, Syllabus, etc.). We may ask for additional documentation at future steps in the process, and can accept them electronically or through campus mail. 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

Incident Information

Supporting Documentation

Submission