Academic Integrity 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.

Nature of this report(Required):

This field is required.

Date of incident(Required):

This field is required.

Location of incident(Required):

This field is required.

Course Name & Number:

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e.g. HUM 150

Involved Parties

Please only include student(s) who may have violated the Academic Integrity Policy.

Name or Organization

ID Number

Questions

Please select the type of academic integrity violation. (See the Academic Integrity Violation policy for detailed definition of each violation.)(Required)

Cheating Collusion and/or Complicity Falsification or Fabrication Misrepresentation of Academic Record Multiple Submissions Plagiarism Other

You must make at least one selection.

Please provide narrative of the violation.(Required) This field is required.

Faculty Only: Per the Academic Integrity policy, if the student has had a prior academic integrity violation(s), the complaint will be automatically forwarded by the Registrar to the Academic Standards Committee for initial review. Per the policy, if the alleged violation is egregious, faculty have the option to have the Registrar forward the complaint to the Academic Standards Committee for initial review. Do you want the Registrar to forward this complaint to the Academic Standards Committee for initial review?

Yes No

You must make at least one selection.

Supporting Documentation

Photos, video, email, and other supporting documents may be attached below. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Email me a copy of this report