Academic Integrity Reporting Form

Background Information

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Your full name:

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e.g. John Doe

Your position/title:

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e.g. Associate Professor, Lecturer, etc

Your phone number:

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xxx-xxx-xxxx

Your NEU email address:

Email address must be of a valid format.

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e.g. j.doe@northeastern.edu

Date of incident(Required):

This field is required.

Location of incident(Required):

This field is required.

Course Code with CRN:

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Found in the upper-left corner of your course in Canvas (e.g. CS1100.40462.202234)

Involved Parties

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

Student First and Last Name (ex. John Smith)

9 digit NUID Number (ex. 001100999, numbers only)

Questions

Please provide a detailed description of the incident/concern using specific concise, objective language.(Required) This field is required.

I have included supporting documentation (turnitin report, copy of paper, copy of exam, etc) for my case (using the additional documentation submission option below)?(Required)

Yes Not Applicable

This field is required.

I have included a copy of the syllabus (using the additional documentation submission option below).(Required)

Yes

This field is required.

Have you spoken with the student(s) about this incident? If so, please detail your conversations with the student(s) in the narrative portion of this report, or as part of your supporting documentation.(Required)

Yes No

This field is required.

College Affiliation(Required) This field is required.

Supporting Documentation (you may submit multiple files)

Please provide supporting documentation here (e.g. syllabus, copies of papers, exams, communications with student, etc). Preferred file types include: PDF, Microsoft Word/Excel, pictures/video files, etc. Code, Zip files, and files requiring specialty software will not likely be functional in your submission. If you are unable to provide a preferred file type, a screen shot is helpful. 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 (you may submit multiple files)

Submission