Report on Academic Misconduct

This form is to be completed by a Course Director or Instructor to refer a matter of academic misconduct to the Dean of the Faculty in which the misconduct occurred. Major academic offences, repeat offences or lesser academic offences that remain unresolved following discussions between the student and the instructor may be referred to the Dean using this form. Course Directors or Instructor may prepare a more detailed written report and attach it to this form.

Instructor name: / Student name: / Student UOIT email:
Course code: / Semester: / Student number: / Year:
1 2
3 4 / Student’s home Faculty:
Name of course:
ð Yes ð No
Is this a second or subsequent academic offence? (Contact the Academic Advising office to see whether any record of a previous academic offence has been deposited into the student’s file)

1. Alleged academic misconduct:

Outline in detail the nature of the alleged academic offence and the facts of the case (e.g., sequence of events, previous meetings with the student regarding this offence, important dates, etc.), along with your reasons for your suspicions:

2. Supporting evidence:

List all materials and documents relevant to this allegation and append them to this report (e.g., work at issue, original source, Turnitin originality report, assignment details, course syllabus and grade breakdown, record of any additional meetings with the student regarding this offence, student’s grade breakdown in course, etc.). If the allegation is plagiarism, please clearly indicate which content is allegedly copied or without a proper source, and if possible, indicate the original source.
Instructor’s signature: / Date:

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Personal information on this form is collected under the authority of the University of Ontario Institute of Technology Act, SO 2002, c. 8, Sch. O. and will be collected, protected, used, disclosed and retained in compliance with Ontario’s Freedom of Information and Protection of Privacy Act R.S.O. 1990, c. F.31. This information will be used for administrative purposes. Questions regarding the collection of your personal information may be directed to UOIT’s Chief Privacy Officer, 2000 Simcoe Street North, Oshawa, ON L1H 7K4, 905.721.8668, ext. 6705, email: .


DOCUMENTS CHECKLIST

Please include the following information and documents in your report:

o  Detailed description of the offence and circumstances

o  Statements from TAs, exam proctors, or other witnesses to the offence (if applicable)

o  Exam Incident Report (with clear details of what occurred, witnesses, actions, etc.) (if applicable)

o  Originality Report from Turnitin.com or other plagiarism detection tool (if applicable)

o  Student’s original essay, exam, test, and/or assignment (i.e., the piece of work in question; for test/exams include both questions and answer sheets)

o  Detailed documentation regarding where the plagiarism or cheating occurred (i.e., please highlight or note exactly where the problem occurs in the piece of work and where it is located in the originating source)

o  Any articles, book pages, or websites, etc., that show where the student plagiarized from (if applicable)

o  Course syllabus and assignment instructions, including the weighting of the assignment

o  The Report on Academic Misconduct (e.g., this form)