California Code of Regulations, Article 2, Student Code of Conduct, Section 41301, includes the following behaviors relating to academic dishonesty, which are subject to disciplinary sanctions.

Which violation(s) are you reporting?

Cheating that is intended to gain unfair academic advantage  

  Plagiarism that is intended to gain unfair academic advantage

Other forms of academic dishonesty that are intended to gain unfair academic advantage

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Name of student

Red ID

Date of this report

In addition to yourself, who witnessed or had knowledge of this incident?

Name TA Student Faculty Other
Red ID   Phone (optional)

Name TA Student Faculty Other
Red ID   Phone (optional)

Course Name

Department

Course #

Incident Date

Professor/Instructor

E-mail

Campus Phone Campus Mail Code

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Please briefly describe the incident.
(In so doing, please be specific: i.e. How did you learn about or discover this incident? What, facts, actions did you observe? What statements were made by persons present?)

As a first step, you as a faculty member may sanction the student at your own discretion regarding the assignment or course grade.

What actions have you taken as a faculty member? (check all that apply)

Assignment Grade Reduction

Course Grade Reduction

Counseled Student

None

Other (please specify)

The role of the judicial officer is to review the student’s conduct at SDSU, including this incident, and intervene in a manner that is consistent with student disciplinary procedures. If found in violation, students are typically required to learn more about academic integrity as a component of their sanction. At the discretion of the judicial officer, further action may be taken for more serious incidents, or for repeated or multiple incidents known to this department, and this may result in a warning, judicial probation, suspension held in abeyance, or suspension, with educational sanctions assigned.

Based on this incident alone, do you recommend review for possible further action, beyond a warning letter, by this office?

Yes No

Students vary in their levels of awareness. Is it your assessment that the student understood, at the time of the incident, that they were committing an act of academic dishonesty?

Most likely did understand

Most likely did not understand

Does your syllabus address academic dishonesty, including cheating and plagiarism, and do you address it in class?

Yes (please attach a copy) No

Thank you for your educational contribution in assisting this student in forming academic values, responsibility, and citizenship.