Judicial Affairs

Academic Misconduct Complaint Form

This form should only be used for academic misconduct complaints. All others should be submitted on the personal misconduct complaint form.

*Indicates a required field
*Last Name
*First Name
Are You ...
Student  Staff  Faculty 
*Name of School and College Department:
*Your E-mail
*Telephone #
( ) -
Name(s) of
Student(s) Involved
*ID # of Student
Student E-mail
Course Name/Title
Course Number
Faculty Member
Teaching Course
Is This ...
Cheating  Plagiarism  Violation of Course Rules  Other 
Date of Incident
/ / (mm/dd/yyyy)
Did You Follow Up With the Student(s)?
(Please Check All That Apply)
I have NOT contacted the student yet.
I spoke to the student in person
I spoke to the student by telephone
I contacted the student via U.S. Mail
I contacted the student via e-mail
*Summary of Incident
(Please include details of misconduct and sanctions imposed by instructor)