Academic Integrity Incident Report

Reporter Information

Please provide your contact information so that we may follow-up with you.

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Your full name and pronouns:

Your position/title:

Your phone number:

Your email address:

Email address must be of a valid format.

Your Department/Academic Unit:

Date of incident(Required):

This field is required.

College/School(Required):

This field is required.

Students Involved

Please list all available information regarding the student(s) involved.

First and Last Name

===[Select Role]===

Alpha numeric SID Number (This is different from the VIP ID) It's okay if you don't have this

DOB (YYYY-MM-DD)

Incident Description

Please enter the term (ex: Fall 2023)(Required) This field is required.

Please enter the course abbreviation (Ex: BIO 101)(Required) This field is required.

Please enter the section number (ex: SEC 60)(Required) This field is required.

Please outline the specific academic integrity concern and the information that supports these concerns. (ie. student information appears to be copied from an online source due to the following factors...). If there is a respondus video, please include the specific times of concern.(Required) This field is required.

Please provide details about the specific assessment. This should include date(s) of administration, method of administration and specific instructions.(Required) This field is required.

What is stated in your course syllabus, lectures or other documentation about academic integrity? (Please include copies of these documents below).(Required) This field is required.

Have you addressed this issue with the student(s) involved?(Required)

Yes No I think so

This field is required.

If so, please document what transpired in the meeting.(Required) This field is required.

What is your typical grade penalty policy if a student is found responsible? (If you are a student reporter, please indicate "n/a" for this question).(Required) This field is required.

I have questions about the academic integrity process or would like to speak with a staff member of the OAI about my report prior to the issue being addressed with the student.(Required)

Yes, please contact me before you meet with the student No, I do not have any questions at this time

This field is required.

If yes to previous question, please list your availability. This field is required.

The Office of Academic Integrity will be sending communications to you shortly after you have submitted this form. At times our communications have been sent to your e-mail SPAM folder. Please contact our office if you have questions about your case progression. For further information about the SPAM filters visit the Division of Information Technology's website.(Required)

I have read and reviewed this information

This field is required.

Supporting Documentation

Please attach PDF copies of all supporting documents including your syllabus, safe assign reports etc.

5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Email me a copy of this report

Academic Integrity Incident Report

This form should be utilized to report potential academic integrity violations. Please read the following helpful information to assist you in completing this report.

Reporter Information

Students Involved

Incident Description

Supporting Documentation

Submission