Non-Academic Misconduct Report #_______________
To be completed by the Office of Student Life & Learning
7128 Ada Blvd.
Edmonton, AB
T5B 4E4
Any member of the Concordia University of Edmonton community or the public who believes, on reasonable
grounds, that a student has engaged in non-academic misconduct (as defined in the Code of Student Conduct,
available online: is encouraged to report the matter to the Vice-President Student Life
& Learning as soon as possible after the incident in question.
You may make a complaint even if you were not the target or victim of the alleged non-academic misconduct.
Allegations of non-academic misconduct may be resolved informally or through a formal hearing process.
Complainant Contact Information
You may be contacted for further information about your complaint, and may be asked to be a witness if the
complaint leads to a formal resolution process. Information related to the investigation and/or resolution of an
allegation of non-academic misconduct will only be made available to those persons who have a need to be
Date of this report:
Date of incident:
Last name:
First name:
Phone number (daytime):
Cellphone number:
Email address:
Affiliation with Concordia:
ID number (if a student):
Name of student(s) alleged to have engaged in non-academic misconduct (if known):
Brief description of the incident:
Are you concerned for your own safety or wellbeing, or the safety of any other person? If so, please
If you become aware of an urgent risk at Concordia,
call Campus Security (780-479-8761) or call 911. Don’t wait!
Please submit this completed form by email to or deliver it to the Office
of Student Life & Learning [Student Success Centre] to the attention of the Vice-President Student Life &
Learning. If you prefer, you may make a complaint in person to the Vice-President Student Life & Learning.
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