Academic Integrity Report

Reporting Party Information

Your full name:

Your phone number:

Your email address:

Email address must be of a valid format.

Date of incident(Required):

This field is required.

Course Academic Supervisor(Required):

This field is required.

Course Subject-Number-Section:

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Ex. ENV-115-91001

Involved Parties

Please list the individuals involved (excluding yourself), including as many of the listed fields as you can provide. For non-students, please list as much identifying information as available. ID number must be 7 characters in length, include the leading zeros if applicable.

Name of Student

Role of Involved Party

Student ID Number

Academic Integrity Description

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

Have you addressed this alleged misconduct with student?(Required)

Yes No

This field is required.

What immediate action, if any, was taken?(Required) This field is required.

Do you need additional assistance from an Administrator?(Required)

Yes No

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.

Email me a copy of this report

Reporting Party Information

Involved Parties

Academic Integrity Description

Supporting Documentation

Submission