EmailMe Form - ABAC Academic Dishonesty Form

Faculty Name

Faculty Email

Student Name

Student Email

Course Name

Student 918#

Conduct Hearing Required

Yes

No

Status of Student Notificaton

Student(s) met with and received written notification from instructor

Student(s) met with and received verbal notification from instructor

Student(s) did not attend meeting or did not respond to instructor's request to meet

Date of Incident

MM / DD / YYYY

Time of Incident

HH : MM AM/PM

Incident Description

Provide a detailed description of the incident.

Location of Incident

Provide specific room numbers or locations within a building. You may state "online" if a class does not meet in person.

Parties Involved

Please list the names of all students involved in this incident, including witnesses. If non-students were present, please list their names as well.

Supporting Documents