X. APPENDIX: HONOR CODE VIOLATION REPORT FORM
HONOR CODE VIOLATION REPORT FORM
Faculty members must complete one form for each student when reporting an Honor Code Violation and/or requesting that the Undergraduate Honor System investigate a case. Return the form to the Undergraduate Honor System in 104 Hillcrest Hall. Please contact the Undergraduate Honor System Office at 540-231-9876 for any questions pertaining to this form or for assistance in resolving this incident.
Please Note: This form is not used to check to see if a student has a prior violation. Please contact the Undergraduate Honor System for assistance with prior violation checks.
Select one of the three options below:
o I would like the Undergraduate Honor System to investigate and resolve this alleged violation of the Honor Code.
You are opting to report an Honor Code violation to the Undergraduate Honor System for investigation and resolution. Complete sections I-III of the form and send it to the Undergraduate Honor System within 10 University business days of observing, discovering, or receiving a report of an alleged incident of academic misconduct. Please provide a brief description of the circumstances of the violation on a separate page. Be sure to include any dates, location, facts leading to suspicion of violation, names of witnesses, syllabus, etc. If you are completing this form on-line, send copies of exams, papers or other relevant evidence to the Undergraduate Honor System, retaining all originals for your own records.
o I have resolved the case through the Faculty-Student Resolution process and I am reporting the outcome.
You are opting to resolve and document the Honor Code violation through the Faculty-Student Resolution process and send the completed form to the Undergraduate Honor System for recording. Honor Code violations that a faculty member chooses to resolve must be reported within 10 University business days after the form has been completed. Complete section I-III and have the student complete section IV. Please submit this form and copies of all corroborating evidence to the Undergraduate Honor System.
o I am recommending a sanction greater than the F* sanction for the course (suspension or expulsion).
If in the investigation of the violation you determine that the sanction for the Honor Code violation should be greater than the F* sanction in the course (i.e., suspension or expulsion), the case is automatically referred to the Undergraduate Honor System Office. Complete sections I-III of the form, along with copies of all corroborating evidence, and send to the Undergraduate Honor System within 10 University business days.
I. THE FOLLOWING STUDENT HAS BEEN CHARGED WITH VIOLATION OF THE HONOR CODE:
Student Name: Student ID & PID: ____________________
Course: Title: Section #:
II. VIOLATION (for more information see the Honor Code) Please check all that apply.
o Multiple Submissions
o Violation of University, College, Department, and/or Course Rules
III. I have recommended the following sanction(s) – if you have resolved the case through the Faculty-Student Resolution process
I recommend the following sanction(s) in referring the case to the Undergraduate Honor System:
- “F*” sanction as the final course grade (university’s recommended sanction)
- Lowered final course grade
- Zero on the assignment
- Academic Integrity Education Program (This educational sanction can be assigned as the only sanction or in conjunction with any of the other sanctions.)
- Hearing before the Undergraduate Honor System Hearing Panel to consider suspension or expulsion from the University
Faculty Name: Dept:
E-mail: Mail Code: Phone:
Faculty Signature: Date: ___________________
IV. TO THE STUDENT:
Please check one of the following boxes, complete the information below and sign. Be sure that you receive a copy of this document. If you have any questions regarding the Honor System process, your procedural guarantees, or would like to speak with someone else regarding this incident, please contact the Undergraduate Honor System at 540-231-9856.
o I acknowledge committing the violation of the Honor Code and accept the sanction(s) recommended by the faculty member.
o I acknowledge committing the violation of the Honor Code but do not accept the sanctions recommended by the faculty member in this document.
o I do not acknowledge violating the Honor Code.
o I would like to speak with a representative from the Undergraduate Honor System prior to completing this form.
Signature of Student: Date:
Local Mailing Address:
City, State, Zip:
E-mail: Cell phone: