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Academic Dishonesty Reporting

This incident report is designed to report incidents of academic cheating, plagiarism, collusion, and fabrication. If you have any questions regarding your particular incident, please contact your Department Chair directly. If your incident is related to a potential Code of Student Conduct violation or Concerning or Threatening Behavior, please complete the incident report located at www.sanjac.edu/incident-report.

Background Information

Your Full Name:

Your Position/Title:

Your Phone Number:

Your Email Address:

Email address must be of a valid format.

Your Campus:

Your Campus(Required):

This field is required.

Date of incident(Required):

This field is required.

Department Name(Required):

This field is required.

Course Name & Number:

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Ex. PHED 1001

Involved Parties

Excluding yourself, please enter information for all parties associated with the incident.

Involved party 1

Student's Name

Select Gender

Select Role

Student's G Number (please include the G)

Questions

Please provide a detailed description of the incident/concern using specific concise, objective language (Who, what, where, when, why, and how).(Required) This field is required.

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

Yes No I tried, but student did not respond

This field is required.

If YES, please describe the conversation. If NO, please discuss why not.(Required) This field is required.

What academic penalties do you propose after discussing the incident with the student?(Required)

None 0 for the assignment/test Required student to redo test/assignment Lower grade on assignment/test F in course Dismissed from program Other

This field is required.

Supporting Documentation

Photos, video, email, and other supporting documents may be attached below. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission

Email me a copy of this report