Report of Academic Misconduct
Refer to Academic Integrity Policy, Appendix A, section 7. This report form is to be used if it has been determined that an offence has occurred as
per section 7.3.1
In situations where an allegation involves more than one student, a separate report must be filed for each student (7.2.1d)
Send the completed form via email attachment, along with supporting documentation to the Academic Dean(AIO), copied to the student,
Department Head (UG students) or Supervisor (MSc students), and Registrar
The accused student has the right to contest the allegation or the academic penalty by submitting a request for referral to the Academic
Dean (AIO) within 5 calendar days of the date of the filing of this report.
Resources to advise students include any member of the University community such as: a MASU representative, Chaplain, Counselling
Services, the Meighen Centre, and the Student Life Office.
Phone Number
Course Number, section
Academic Term
Number of students involved (separate
form for each)
Accused student:
Last Name
First /Preferred Name
Student ID #
Attached Information:
Description of incident, date, time, details (page 2 of this document)
Synopsis of meeting(s) with student, in person or via email (or explanation of why meeting(s) not possible) (see 7.2.1) (page 2 of this document)
Copies of relevant or related correspondence with student involved with case
Evidence: copies of work in question, any other relevant materials such as source that was plagiarized, test that was copied, etc.
Relevant assignment/test/exam as distributed to class
Course outline
Recommended academic penalty (by instructor only):
ducative action (e.g. rewrite assignment; letter of reprimand; participation in educational or remedial academic activity)
Please specify: ________________________________________________________________________________
Academic penalty (e.g. lower grade or failure on the assignment/test/exam; failure in the course
Please specify: _
Alleged Offence:
Please select one of the following. Examples of
academic misconduct include but are not limited to the following:
the severity of th
e offence, including its impact on others (students, faculty or staff, members of the community);
relative weight of the assignment;
the student's year of study
the student admits guilt, accepts responsibility, and is amenable to educative remedies;
extenuating circumstances that may help explain the action taken by a student;
any aggravating factors
Considerations: (refer to section 4 of the Academic Integ
rity Policy
Plagiarism or misrepr
esenting someone else's work, whether ideas, words, creative works, published or unpublished, as your own
Submitting work for academic credit for which credit has previously been obtained or that is being submitted for credit in another course, without written
permission from the Instructor(s)
Falsifying results in lab experiments, field exercises, or other assignments
Copying someone else's work on assignments, tests, or exams
Use of unauthorized aid or assistance in tests or exams
Collaborating on assignments that were designated by the Instructor as individual work
Impersonating another student, or knowingly allowing someone to impersonate you, in an assignment, test, or exam
Using someone else's computer account or using your computer account for unauthorized purposes
Interfering with or damaging someone else's academic work including their access to campus resources
Obtaining, viewing, or sharing information about an assignment, test, or exam
Knowingly helping someone else engage in academically dishonest behavior
Submitting false information or false medical documentation or misrepresenting personal circumstances to postpone or gain an advantage for any academic work
Tampering with academic transcripts or records and/or submitting false credentials
Any other form of misrepresentation, cheating, fraudulent academic behavior, or other improper academic conduct of comparable severity
To be confirmed by the Registrar: record of previous report on file
Yes No
Additional Information:
Description of incident, date, time, details
Synopsis of meeting(s) with student, in person or via email (or explanation of why meeting(s) not possible) (see 7.2.1)
Signature: Date (dd/mm/yy):____________________________
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