Academic Misconduct Violation Report-Undergraduate

Undergraduate Academic Misconduct Violation Report

Please fully complete the form. Your description of the violation will be used in the template response letter. Please be specific and concise.

Instructor Name*

First Name

Last Name

Course and Section #*

ex. ESC 250 sec 1

Semester & Year*

ex. Fall 2018

Type of Delivery of Class/Lab*

Student's Name*

First Name

Last Name

CSU ID Number*

Date of Incident*

Alleged Violation:*

select one

If Other, please list:

Proposed sanction*

Minor Infraction (assignment worth less than 20% overall course grade) - Recommendation: Student earns 0 points on the assignment, test, exam, or project. Major Infraction (assignment worth more than 20% overall course grade) - Recommendation: Student earns an F in the course. Submit a Change of Grade Form to the Registrar to prevent student from dropping course. Note: CSU Policy prevents students from dropping a course that involves a major infraction of academic misconduct. Other

select one

If Other, please list:

Description of the violation. Please write concisely providing imperative details. Your description will be copy and pasted into the template response letter which will be sent to the student either electronically or mailed in a hard-copy format.*