Academic Integrity Incident Report

 
Faculty Name:
Position/Title:
Faculty Email Address:
Faculty Phone (including area code):
Office Address (Bldg./Number):
1. Student Full Name (First, Middle, Last):
Last 4 digits of Student ID:
Student Email Address:
2. Student Full Name (First, Middle, Last):
Last 4 digits of Student ID:
Student Email Address:
3. Student Full Name (First, Middle, Last):
Last 4 digits of Student ID:
Student Email Address:
4. Student Full Name (First, Middle, Last):
Last 4 digits of Student ID:
Student Email Address:
(If more than 4 students involved, submit an additional Incident Report Form.)
Course Name (e.g. EDHE):
Course Number (e.g. 737A):
Class Section (e.g. 001):
Semester:
Meeting Time (e.g. T/R 11-12:15):
Classroom Location:
Date of Incident:
Location of Incident (e.g. Classroom, computer lab, etc.)
Dean/Dept. Chair Name:
Dean/Dept. Chair Email Address:
Allegations (Check all that apply):  

Giving or receiving unauthorized assistance, or attempting to give or receive such assistance, in connection with the performance of any academic work.

Unauthorized use of materials or information of any type or the unauthorized use of any electronic or mechanical device in connection with the completion of any academic work.

Access to the contents of any test or examination or the purchase, sale, or theft of any test or examination prior to its administration.

Use of another person’s work or ideas without proper acknowledgment of source.

Intentional misrepresentation by word or action of any situation of fact, or intentional omission of material fact, so as to mislead any person in connection with any academic work (including, without limitation, the scheduling, completion, performance, or submission of any such work).

Offering or giving any favor or thing of value for the purpose of influencing improperly a grade or other evaluation of a student in an academic program.

Conduct intended to interfere with an instructor’s ability to evaluate accurately a student’s competency or performance in an academic program.

Other: (Please explain below)

Please provide a detailed description of the incident using specific concise, objective language. Please include any meetings, phone calls, etc. you may have had with the student(s). Forward all documentation to the Office of Academic Integrity at the Byrnes Building, Suite 201 and/or any electronic communication/supporting documentation to academicintegrity@sc.edu. Please call 7-4333 with any additional questions.