_________________ ______________________ _______________________
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_______________________________ _______________________________
BOSSIER PARISH COMMUNITY COLLEGE
A
CADEMIC MISCONDUCT STUDENT COUNSELING FORM
Proceedings Status
Name and ID#_______________________________Course Name/Number__________________
_____Proceedings against the student are dismissed on _______________________________.
Instructor Signature
Academic Dean Signature Date of Student Notification
OR
_____The student is placed under Sanction(s)______________as outlined in the Academic
Misconduct Policy, Section II. The sanction(s) is (are) as follows:_________________________
_____The student agrees to accept the sanction(s) stated above for the described offense.
Student’s Signature Date
OR
_____The student requests a meeting with the Vice Chancellor for Student Services and/or a
hearing of this case by the Academic Misconduct Appeals Committee, and he/she must file a
written statement within four working days to the Vice Chancellor for Student Services. The Vice
Chancellor may dispose of a violation as being unfounded, may impose administrative sanctions
without a hearing, or may refer the violation to a formal disciplinary hearing or formal academic
misconduct hearing. The student is also aware that Student Services will place a temporary hold
on his/her academic records pending resolution of the academic misconduct allegations.
Student’s Signature
Date
Student Services
Revised: April, 2018
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