Academic Dishonesty Form

This Form is for Faculty Only.

Please use this form to report incidents of suspected academic dishonesty. Submitting this information helps ensure consistent application of academic integrity policies, supports due process for students, and allows the institution to track patterns and respond appropriately. Please provide as much detail as possible.

Academic Dishonesty Form

Student and Course Information

Student Name: *

First

Last

Student ID: *

Reporting Faculty Name: *

First

Last

Reporting Faculty Email: *

Email

Confirm Email

Course Name and Number: *

Assessment Title(s) (e.g. Test 1): *

Violations Being Reported

As the instructor of record, it is my observation that the above listed student has committed the academic dishonesty violation(s) of (Check all that apply): *

• Cheating
• Copyright Infringement
• Complicity
• Falsification, Fabrication, or Misrepresentation
• Multiple Submission
• Outside Sourcing
• Plagiarism
• Unauthorized Use of AI

Details Regarding the Violation(s): *

Upload documentation of any communication with the student regarding academic dishonesty (optional):

Click or drag files to this area to upload. You can upload up to 3 files.

are it my

Upload any supporting documents related to your report (optional):

Click or drag files to this area to upload. You can upload up to 3 files.

The following sanction(s) have been imposed or are recommended (Check all that apply):

• Reduced or Failing Grade on Assessment
• Zero Credit on Assessment
• Redo the Assessment
• Alternate Assessment
• Failing Grade in Course (pending Assistant Dean/Dean approval)
• Administrative Withdrawal (pending Assistant Dean/Dean approval)
• Due to the nature of the academic dishonesty or past experience of academic dishonesty regarding this student, I recommend a review of the circumstances to determine if additional sanctions are warranted.

New points/grade:

Assessment points cap:

• Yes
• No

If yes, maximum points student can earn on new assessment:

Name of alternate assessment:

Maximum points student can earn on alternate assessment:

Submit