CLAS Report of Academic Misconduct

Reporter Information

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Instructor's Name:

Instructor's Title:

Instructor's Email Address:

Email address must be of a valid format.

Status of Reported Student(Required):

This field is required.

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Is the student being reported an undergraduate or graduate student?

Date of incident(Required):

This field is required.

Involved Students

To adhere to FERPA regulations, please submit a separate form for each student even if multiple students are involved in this case.

Name of Student

University ID Number

UI email address

Questions

Session(Required) This field is required.

Course Number (example: CHEM:1070)(Required) This field is required.

Course Name(Required) This field is required.

Please select the type of academic misconduct from the list (select all that apply):(Required)

Cheating on Quizzes and Exams Plagiarism Unauthorized Collaboration Willful Misrepresentation Facilitating Academic Dishonesty of Others Other

You must make at least one selection.

If you selected other as the type of academic misconduct, please provide more information: This field is required.

Description of Incident and Related Evidence. Note: This information is shared with the student.(Required) This field is required.

Instructor's Sanction for Misconduct: such as, grade reduction. According to CLAS policy, the instructor assigns the first level of the student's sanction. Note: This information is shared with the student.(Required) This field is required.

Briefly describe your contact with the student and the student's perception of the incident: Note: This information is shared with the student.(Required) This field is required.

Supporting Documentation

Upload documents showing evidence of academic misconduct here, such as, Turnitin reports or photo or video evidence. Note: These documents may be shared with the student. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

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Reporter Information

Involved Students

Questions

Supporting Documentation

Submission