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Academic Integrity Report Form


Background Information

 
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Involved Parties

Please provide a detailed description of the incident/concern using specific concise, objective language.

Involved party 1

Questions

Please refer the University of Southern Indiana Rights and Responsibilites: Code of Student Behavior, Section 5.0 for a full description of the Academic Integrity policies. Select the policy that best relates to the behavior in question.

5. 1. A. Cheating: Cheating is intentionally using or attempting to use unauthorized materials, information, or study aids in any academic exercise. Examples of cheating include but are not limited to: using external assistance during any examination unless the instructor has specifically authorized (including but limited to: books, calculators, notes, formula lists, cues on a computer, photographs, cell phones, symbolic representation, and electronic devices; copying from another student’s work. (including but limited to: a test, paper, project, product, performance, or electronic document of file); completing assignments for someone or having someone complete an assignment for them; taking a test for someone; having someone take a test for them; submitting the same academic work more than once without permission from all instructors who may be involved; obtaining a copy of an examination from an unauthorized source; and/or submitting another’s works as their own, using commercial term-paper companies, past papers, and/or AI generative tools.
You must make at least one selection.
5. 1. B. Interference: Interference is behavior that detracts from a safe, quality learning environment of others' educational goals. Examples of interference include but are not limited to: disruptive classroom behavior, disrespectful classroom behavior, or failure to comply with instructor's instructions.
You must make at least one selection.
5. 1. C. Fabrication: Fabrication is creating something for the purpose of deception. Examples of fabrication include, but are not limited to: creating false citations; falsifying research, lab, clinical activities, data, or source material; and/or using AI generative tools.
You must make at least one selection.
5. 1. D. Plagiarism: Plagiarism is using the work and/or ideas of another person as if it is your own. Examples of plagiarism include but are not limited to: quoting another person’s actual work without appropriate citation; using another person’s ideas, opinion, or theory without appropriate acknowledgement; using facts, statistics, or other illustrative material without appropriate citation; and/or using AI generative tools.
You must make at least one selection.
5. 1. E. Academic Sabotage: Academic sabotage is an intentional impediment of others' academic progress. Examples of academic sabotage include but are not limited to: destroying another’s work, impeding another from completing their work; removing books, papers, journals and/or electronic devices from a student or the University; changing another students data, papers, results, and/or assignments; and/or defacing resources.
You must make at least one selection.
5. 1. F. Facilitating Academic Dishonesty: Facilitating academic dishonesty is intentionally or knowingly helping or attempting to help another student commit an act of academic dishonesty. Examples of facilitating academic dishonesty include but are not limited to: allowing another to copy assignments, papers, examination answers, or lab results; providing copies of unauthorized examinations; providing copies of papers, examinations, or lab results; and/or developing methods for exchanging information during an examination.
You must make at least one selection.
5. 1. G. Violation of Research or Professional Ethics: Violations in this category include professional ethical codes, University code of conduct, ethical research protocol, and/or any professional standard communication by a professor or program. Examples of violations of research or professional ethics and/ or standards include but are not limited to: violation of professional ethical codes of behavior or professional standards; conducting research without completing University procedures; violation of HIPPA; misuse of funding; and/or misuse of positions, such as teaching assistant, graduate assistant, or student worker.
You must make at least one selection.
5. 1. H. Violations Involving Potentially Criminal Activity: Violations in this category include actions such as theft, fraud, forgery, and/or distribution of unauthorized materials. Examples of violations include but are not limited to: stealing material; including electronic files; forging any University documents such as grade change forms; falsifying transcripts or grades; selling stolen materials; and/or violating state and federal regulations governing a profession.
You must make at least one selection.
5. 1. I. Repeated Academic Integrity Violations: Students found responsible of multiple Academic Integrity-related violations may be referred to the appropriate academic College Dean's Office for further action. Being found responsible of multiple Academic Integrity violations may result in disciplinary probation, removal from the academic program, removal from the academic college. and/or expulsion from the University.
You must make at least one selection.
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Have you discussed the incident with the student?
You must make at least one selection.
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Supporting Documentation

If your information is in paper form, please scan and upload the electonic documents to the IR. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Select copy recipients

Please select the department head, assistant dean, and/or dean(s) of the appropriate college.
Please select the department head, assistant dean, and/or dean(s) of the appropriate college.

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Submission