Fill - Free fillable Form VI.F.1.: Report: of Non-Academic Misconduct (Lone Star College System) PDF form

A-7

Form VI.F.1.: Report

of Non-Academic Misconduct

Any individual may use this form to report non-academic student misconduct. This form

should be submitted to the appropriate Chief Conduct Officer (list maintained at

www.lonestar.edu/ChiefConductOfficers).

Lone Star College strives to maintain a safe, orderly College community. Please describe the

facts, circumstances, and existing evidence of the misconduct, including names, dates, times,

and places, in as much detail as possible. List the name of any person (and contact

information, if available) who may have additional facts regarding the misconduct. Attach

additional sheets as necessary.

_________________________________________________________________________________________________________

I understand that any statement I make on this Form VI.F.1 which is false, misleading, or not

made in good faith may be grounds for discipline.

____________________________________ ______________________________________ __________________

Printed Name Signature Date

For Office Use Only Date Received: ___________________________________________

Receiving Employee: _____________________________________ ____________________________________

Printed Name Signature

click to sign

signature

click to edit

click to sign

signature

click to edit

A-8

Form VI.F.2.: Chief Conduct Officer’s Decision

on Reported Non-Academic Misconduct

Chief Conduct Officers should use this form to memorialize their decisions regarding

reported non-academic misconduct. If the Chief Conduct Officer decides that a student has

engaged in non-academic misconduct, this form must be sent to the student (“Respondent”)

within ten working days of when the Chief Conduct Officer received the report of non-

academic misconduct.

Decision

I find that the Respondent ______ did or ______ did not engage in non-academic misconduct.

This decision represents my best judgment following a sufficient investigation into the

reported non-academic misconduct.

____________________________________ ______________________________________ __________________

Printed Name Signature Date

Investigation Narrative

Summarize the investigation into the reported non-academic misconduct. Attach additional

sheets as necessary. Attach copies of related Forms VI.F.1. and other related written reports.

_________________________________________________________________________________________________________

Respondent Information (if applicable)

Name: _____________________________________________________ LSC ID No.: ____________________________

Email: _____________________________________________________ LSC college: ____________________________

Non-academic misconduct: _________________________________________________________________________

_________________________________________________________________________________________________________

Sanction(s) Imposed: ________________________________________________________________________________

_________________________________________________________________________________________________________

If you have been suspended or expelled, then you have the right to request a hearing

before a Discipline Committee by replying to this email with your request within five

working days. If you do not request a hearing, this decision will become final at 5:00

p.m. central time on .

click to sign

signature

click to edit

A-9

Form VI.F.3.: Notice

of Discipline Committee Hearing

When a student (“Respondent”) entitled to a hearing before the Discipline Committee

requests such a hearing, the Chief Conduct Officer shall send this completed form or a written

communication containing equivalent information should be sent to the following: (1) the

Respondent; (2) the college president for the college to provide the Discipline Committee for

the hearing (contact the Office of the General Counsel for the appropriate college); (3) the

Chief Conduct Officer’s college president; and (4) the Office of the General Counsel. If the

hearing will be a joint hearing, list all Respondents. Include with this form the Forms VI.F.2.

and VI.F.1. related to the hearing.

Respondent Name(s): _______________________________________________________________________________

LSC college to provide Discipline Committee: _____________________________________________________

Chief Conduct Officer whose decision will be reviewed: __________________________________________

Hearing Date: ___________________________ Hearing Time: ______________________ Central Time

Hearing Location: ____________________________________________________________________________________

_________________________________________________________________________________________________________

All hearing participants should arrive at least 15 minutes early on the date of the hearing.

The hearing will be conducted according to the policies found in the Lone Star College Board

Policy Manual Section VI.F. and Procedures adopted thereunder. A copy of these policies and

procedures are attached hereto.

RecommendedSanction(ifapplicable)

We recommend that Respondent receive the following sanction for non-academic

misconduct:

_______ Expulsion; ______ Suspension for up to ______ weeks from _________________ college(s) or

_______ all colleges, including centers, workforce, and online courses; or

______ Other sanction: ________________________________________________________________________________

_________________________________________________________________________________________________________

This decision represents our best judgment regarding the subject matter of the hearing.

____________________________________ ______________________________________ __________________

FormVI.F.4.:Decision

ofDisciplineCommittee

Discipline Committees should use this form to record their decisions according to Section

VI.F. of the Policy Manual and the procedures adopted thereunder. This decision must be

signed by at least three members of the Discipline Committee who attended the hearing for

this matter.

1

The Chief Conduct Officer’s decision (Form VI.F.2.) that preceded the hearing

should be attached to this form.

Decision

Based on the evidence presented at the hearing, we find that ___________________________________

(Respondent) ______ did or ______ didnot engage in the following non-academic misconduct:

_________________________________________________________________________________________________________

Printed Name Signature Date

____________________________________ ______________________________________ __________________

Printed Name Signature Date

____________________________________ ______________________________________ __________________

Printed Name Signature Date

____________________________________ ______________________________________ __________________

Printed Name Signature Date

____________________________________ ______________________________________ __________________

Printed Name Signature Date

1

Student committee members are not required to sign this Form. They may document their agreement or

disagreement with the committee’s decision verbally to the other committee members.

A

-10

A-11

Form VI.F.5.: Appeal

of Discipline Committee Decision

Either the College (through a Chief Conduct Officer) or the Respondent (personally or

through a representative) may appeal a Discipline Committee’s decision by submitting this

completed form to the Office of the Vice Chancellor of Student Success within five working

days after receiving the Discipline Committee’s decision. Late appeals will not be considered.

Attach the Discipline Committee decision (Form VI.F.4., with all accompanying

documentation) being appealed and use the space below to explain why this decision should

be modified or reversed. Attach additional sheets as necessary. Also, state what final

outcome you would like for this matter.

_________________________________________________________________________________________________________

Requested Final Outcome

_________________________________________________________________________________________________________

I understand that by appealing this matter, the Vice Chancellor of Student Success will have

complete discretion over this matter and may reach whatever decision and impose whatever

sanction, if any, that the Vice Chancellor of Student Success considers appropriate. I also

understand that the Vice Chancellor of Student Success’s decision is final.

____________________________________ ______________________________________ __________________

Printed Name Signature Date

For Office Use Only Date Received: ___________________________________________

Receiving Employee: _____________________________________ ____________________________________

Printed Name Signature

click to sign

signature

click to edit

click to sign

signature

click to edit

A-12

Form VI.F.6.: Final Decision After Review

of Appealed Discipline Committee Decision

The Vice Chancellor of Student Success shall use this form to memorialize his or her final

decision regarding an appealed Discipline Committee decision.

Within five working days of receiving an appeal, this completed form must be sent to the

following: (1) the Respondent; (2) the Chief Conduct Officer; (3) the Chief Conduct Officer’s

college president; and (4) the Office of the General Counsel. A copy of all relevant forms

related to this appeal should be attached to this decision.

Final Decision

After reviewing this matter, the Discipline Committee’s decision is:

______ Affirmed; ______ Reversed; or

______ Modified as follows: ___________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________.

This decision represents my best judgment in this matter.

____________________________________ ______________________________________ __________________

Printed Name Signature Date

click to sign

signature

click to edit

A-13

Form VI.F.7.: Discipline Agreement

At any time, the College may choose to enter into an agreement to impose certain sanctions

in exchange for a student admitting that he or she engaged in non-academic misconduct. Any

such agreement must be in writing, signed by the Chief Conduct Officer and the student, and

should use this form or contain substantially similar information.

Student’s Admission

I unconditionally admit to having engaged in the following non-academic misconduct:

_________________________________________________________________________________________________________

_______________________________ ____________________ _________________________________ __________________

Printed Name LSC ID No. Signature Date

Chief Conduct Officer’s Judgment

I impose the following sanction on the student for the admitted non-academic misconduct:

_________________________________________________________________________________________________________

The imposed sanction represents my best judgment of what is an appropriate sanction,

considering all applicable facts and circumstances.

____________________________________________ ______________________________________ __________________

Printed Name Signature Date

click to sign

signature

click to edit

click to sign

signature

click to edit

Fill Online, Printable, Fillable, Blank Form VI.F.1.: Report: of Non-Academic Misconduct (Lone Star College System) Form

Related forms

Fillable Form VI.F.1.: Report: of Non-Academic Misconduct (Lone Star College System)

Fill Online, Printable, Fillable, Blank Form VI.F.1.: Report: of Non-Academic Misconduct (Lone Star College System) Form

Related forms

First 20 documents completely FREE!