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UNL Student Conduct & Community Standards Academic Integrity Report Form

This form is intended to be used for reporting the academic misconduct of UNL students that may be in violation of the University of Nebraska Student Code of Conduct. Information submitted using this form will be reported to the Office of Student Conduct & Community Standards for review.

Please review the Faculty Senate Policy related to Academic Integrity here: https://www.unl.edu/facultysenate/Academic%20Integrity%20Policy%20on%20Sanctions%20Related%20to%20Academic%20Integrity.pdf

Background Information

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Your full name:

Your position/title:

Your phone number:

Your email address:

Email address must be of a valid format.

Your physical address:

Date of incident(Required):

This field is required.

Time of incident:

Reporting Department(Required):

This field is required.

Specific class number:

Involved Parties

Please name the students involved in the incident.

Involved party 1

Name

Select Role

ID Number

Questions

Please provide a detailed description of the incident, using specific, concise, objective language (who, what, where, when, why and how).(Required) This field is required.

Per Faculty Senate Policy: "Prior to reporting a perceived act of academic dishonesty, imposing any associated sanctions or making a recommendation for additional discipline, the faculty member must attempt to discuss the allegation with the student, allowing up to two business days, defined by the university schedule, for a response." Have you attempted to meet with the student to discuss the incident?(Required)

Yes No

This field is required.

What was the violation? Select all that apply.(Required)

1. Cheating 1a. Copying from another student’s exam, assignment, or project. 1b. Using materials during an exam or for an assignment that are not authorized by the instructor. 1c. Using devices during an exam that are not authorized by the instructor. 1d. Taking any materials out of the exam room (for example, the exam itself or scratch paper) that the exam instructions prohibit students from taking. 1e. Making an electronic copy of part or all of an exam, unless the instructions authorize making a copy. 1f. Possessing a copy of an exam or assignment that the student knows or should have known that they are not authorized to have. 1g. Working on an exam or assignment with someone else, unless group work has been authorized by the instructor. 1h. Taking an exam for another student, or allowing their exam to be taken by someone else. 1i. Taking all or part of work that someone else prepared and submitting it as one’s own. 1j. Taking all or a substantial part of an assignment submitted for one course and submitting it in another course, without the authorization of the instructor for that course. 2. Dishonesty, Falsification, and Fabrication 2a. Making false statements to avoid taking an exam or submitting an assignment at the scheduled time. 2b. Making false statements to avoid a penalty for failing to take an exam or submit an assignment at the scheduled time. 2c. Making up or purposefully misstating information or sources in any assignment or research project. 2d. Engaging in plagiarism by presenting the words or ideas of another person as one’s own. 2e. Making changes to a graded exam or assignment and then representing that the changes were part of the original exam or assignment. 3. Harmful Academic Action Towards Others 3a. Interfering with another person’s research or academic work. 3b. Knowingly making false charges that another student violated these Standards. 4. Improperly Helping Others 4a. Helping another student on an exam or an assignment when the student is not authorized to receive help. 4b. Knowingly helping another student violate these Standards, including, but not limited to, sharing an instructor’s teaching materials without permission. 4c. Unauthorized distribution, electronically or otherwise, of an instructor’s course materials. 5. Failing to Follow the Rules 5a. Failing to follow the instructions of an exam proctor. 5b. Failing to follow testing center rules.

You must make at least one selection.

Academic Sanction (Select all that apply.)(Required)

Reduced grade on assignment, paper, quiz or exam Zero on assignment Grade of F on Transcript for the Course Other (please contact the Office of Student Conduct and Community Standards to discuss (402) 472-2021).

You must make at least one selection.

Non-Academic sanctions recommended to the Office of Student Conduct and Community Standards: (Mark all that apply.) Please note that SCCS has discretion in imposing non-academic sanctions.(Required)

I recommend the student be assigned to complete an online academic integrity seminar. I recommend the student receive University Probation. (Probation is for a designated period of time and includes the probability of more severe disciplinary sanctions if the Respondent is found to violate the terms of the probation or any provision of the Student Code during the probationary period.) I recommend University Suspension. (Separation of the Respondent from the University for a definite period of time, after which the Respondent is eligible to return. Conditions for readmission may be specified.) I recommend University Expulsion. (Permanent separation of the Respondent from the University.) I recommend Revocation of Admission and/or Degree. (Admission to or a degree awarded from the University may be revoked for fraud, misrepresentation, or other violation of University Standards in obtaining the degree, or for other serious violation committed by a student prior to graduation.) I recommend Withholding Degree. *The University may permanently withhold awarding a degree, or withhold the award of a degree pending the completion of the Disciplinary Procedures, including the completion of all sanctions imposed, if any.) I choose not to provide input on non-academic sanctions

You must make at least one selection.

What is the best phone number to reach you at if we have additional questions? This number will not be provided to the students involved.(Required) This field is required.

Your academic department(Required) This field is required.

I request to receive information about the outcome(s), including non-academic sanctions, directly related to this report of Academic Misconduct.

Yes No

This field is required.

Supporting Documentation

Please attach any relevant assignment(s), test(s), instructions for assignments/tests, and a copy of the course syllabus. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission

Email me a copy of this report