Academic Dishonesty Reporting Form

Reporter Information

Please provide your information for contact and follow up.

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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.

Location of incident(Required):

This field is required.

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This could be the classroom or select off campus if submitted online

Specific location if known:

Involved Parties

Which students were involved in the situation?

Name

Select Gender

How were they involved

ID Number

Email address

Additional Required Information

Please provide as much detail as possible when answering the following questions:

What is the course name and number?(Required) This field is required.

What is the coursework in which academic dishonesty is suspected?(Required) This field is required.

What percentage of the course grade does the coursework constitute?(Required) This field is required.

Do you consider the incident to be one of minor or major academic dishonesty?(Required)

Minor Academic Dishonesty: This option indicates that the suspected violation was non-egregious, and that the student should receive additional education in order to avoid future violations or suspected violations. Major Academic Dishonesty: This option indicates that the suspected violation was egregious, and that the student should receive a hearing from an Academic Dishonesty Hearing Panel (ADHP).

This field is required.

Do you wish to be present for an ADHP if one must be convened? (An ADHP will automatically be convened if there is already another report on file).(Required)

Yes

You must make at least one selection.

If you wish to be present for an ADHP, what is your availability for the next two weeks? (Panels generally last no longer than one hour)(Required) This field is required.

Please provide a complete summary of the incident. Your summary must include the following: 1. How you became aware of the misconduct; 2. A description of the misconduct (see Academic Integrity Policy for violations); 3. A description of any physical evidence (attach evidence if available).(Required) This field is required.

Supporting Documentation

Please provide the following:
• evidence which may support allegations of plagiarism, including photocopies or citations of original materials.
• if appropriate, a diagram of the locations of the student(s) involved and witnesses if applicable; 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Email me a copy of this report

Reporter Information

Involved Parties

Additional Required Information

Supporting Documentation

Submission