Non-Academic Misconduct Report #_______________
To be completed by the Office of Student Life & Learning
7128 Ada Blvd.
Edmonton, AB
T5B 4E4
concordia.ab.ca
1.866.479.5200
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: www.concordia.ab.ca) 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
informed.
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
explain:
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 barbara.vaningen@concordia.ab.ca 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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