Academic Integrity Violation Report Form

Faculty should use this form to report an instance in which they believe a student has violated the ASU Academic Integrity Policy. Submission of this form will serve as notification to The College of Liberal Arts and Sciences. After receipt of the form, a designated representative of The College will contact the faculty to discuss the violation, sanctions, and next steps in the Academic Integrity Violation process.

Additional Information

Office of the University Provost Academic Integrity overview

For Faculty - The College of Liberal Arts and Sciences Academic Integrity Resources

For Students - The College of Liberal Arts and Sciences Academic Integrity Resources

Your Information

First name *

Last name *

E-mail *

Department *

Director/Chair e-mail *

This person will receive a copy of the report form submission.

Student Information

Student Name *

Student ASU ID# *

Graduate Student? *

Yes

No

Course Information

Course prefix *

Course number *

Schedule line number *

Semester *

Academic Year *

Incident Information

Date incident occurred *

Month

Day

Year

Please summarize the Academic Integrity Policy violation *

What evidence do you have of this Academic Integrity Policy violation *

Evidence and Documentation - Additional files

Up to three documents can be submitted. Additional documents can be sent directly to amanda.a.smith@asu.edu
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png txt rtf html pdf doc docx odt ppt pptx odp xls xlsx ods xml avi mov mp3 ogg wav bz2 dmg gz jar rar sit tar zip.

Evidence and Documentation - Additional files

Up to three documents can be submitted. Additional documents can be sent directly to amanda.a.smith@asu.edu
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png txt rtf html pdf doc docx odt ppt pptx odp xls xlsx ods xml avi mov mp3 ogg wav bz2 dmg gz jar rar sit tar zip.

Evidence and Documentation

Attach any documents associated with academic integrity violation. Documents can include Turn-It-In reports, email correspondence related to the allegation, copies of original source material, course announcements, etc. If your evidence is based on test taking videos, such as RPNow, please contact proctoring@asu.edu to request that the videos are shared with Amanda Smith at aasmith9@asu.edu.
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png txt rtf html pdf doc docx odt ppt pptx odp xls xlsx ods xml avi mov mp3 ogg wav bz2 dmg gz jar rar sit tar zip.

Attach Course Syllabus *

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png txt rtf html pdf doc docx odt ppt pptx odp xls xlsx ods xml.

Have you discussed the incident with the student? *

Yes

No

If “Yes”, please summarize your conversation with the student

If 'No', why not

Note that The College may request that the sanction be modified base on a number of variables associated with the violation. Questions regarding sanctioning can be sent to TheCollegeDean@asu.edu.

If you have issued sanctions to the student as a result of this violation, what were they?

If you have not issued sanctions to the student, what sanctions do you recommend for the violation?