Academic Misconduct Report Form
Student Information
Name
ID#
Degree
Program/Major
Email
Semester
Level
Semester when the alleged offence occurred:
Course Code:
Instructor:
Department/School:
Assessment Information:
i. related to (i.e. assignment #1, midterm, final
exam):
ii. percent of final grade:
iii. due date:
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Details of Alleged Offence
Consult the Undergraduate Calendar or Graduate Calendar for more information on Academic
Misconduct. Please select as many options that may apply. If you are unsure of the exact offence, leave
blank.
1.) Misappropriation of Other's Work
1. Plagiarism
Plagiarism is misrepresenting the ideas, expression of ideas or work of others as one's own.
2. Copying
Copying is similar to plagiarism in that it involves the appropriation of others' work as one's
own. It includes copying in whole or in part another's test or examination answer(s), laboratory
report, essay, or other assignment.
3. Unauthorized Co-operation or Collaboration
It is an offence to co-operate or collaborate in the completion of an academic assignment, in
whole or in part, when the instructor has indicated that the assignment is to be completed on
an individual basis.
2.) Misrepresentation and Fraud
1. Impersonation
Impersonation involves having someone impersonate oneself, either in person or electronically,
in class, in an examination or in connection with any type of academic requirement, course
assignment or material, or of availing oneself of the results of such impersonation.
2. Falsification
It is an offence to submit or present false or fraudulent assignments, research, credentials, or
other documents for any academic purpose.
3. Withholding
It is an offence to withhold records, transcripts or other academic documents with the intent to
mislead or gain unfair academic advantage.
4. Unauthorized Aids and Assistance
It is an offence to use or possess an unauthorized aid, to use or obtain unauthorized assistance,
or to use or obtain prohibited material in any academic examination or term test or in
connection with any other form of academic work.
3.) Improper Access and Obstruction
1. Preventing Access to Materials
It is an offence to alter, destroy, hide, remove without authorization, or in any other way
improperly restrict access to library, electronic or other materials intended for general
academic use.
2. Obstruction and Interference
It is an offence to obstruct or otherwise interfere with the scholarly activities of another, or to
alter or falsify the work of others, in order to gain unfair academic advantage.
3. Improper Access
It is an offence to improperly obtain through theft, bribery, collusion, or otherwise access to
confidential information, examinations or test questions or to gain undue academic advantage
as a result of such behaviour.
4. Improper Dissemination
It is an offence to publish, disseminate or otherwise make public to a third party without prior
written consent, confidential information.
4.) Aiding and Abetting
Knowingly aiding or abetting anyone in committing any form of academic misconduct is itself
academic misconduct and subject to this policy.
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Please provide details of the alleged misconduct and your evidence-gathering activities and relevant
dates (attach additional pages and documentation as necessary):
Please forward the following documentation with the case (as applicable):
course outline
assignment or examination instructions
a copy of the student work with suspicious areas highlighted or otherwise clearly noted
information about the student performance on other assignments in the course
e-mail or other correspondence related to the case
witness statements (as appropriate)
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Student notification is required. Please verify the date and method of notification:
Method:
Date:
Instructor approval:
Signature:
Date:
Chair or Director approval:
Signature:
Date:
Please select...
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