VIRGINIA WESTERN COMMUNITY COLLEGE
REPORT OF STUDENT MISCONDUCT FORM
Campus Police was called:
No
Yes
Yes No
Student Name:
Student EmplID:
Description of Incident:
Course (if applicable):
Semester and Year:
Submitted By:
Name Date
Reviewed By:
Dean Date
Report set to Dean of Student Services Office on:
Date Notification of Due Process
Letter was emailed to student
Student was informed of appeal
procedures
To report student misconduct, complete the following section, attach any supplemental evidence, sign the
form and submit the case to the appropriate Dean for review and signatory approval. If you do not report to a
dean, submit the form directly to the Dean of Student Services.
The following section will be completed by the Dean of Student Services or designee
VWCC Student Email Address:
Print Form