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Academic Dishonesty Report Form Please complete the following form to report proven or suspected cases of academic dishonestly. It is very important that you report all cases, even if you have handled them. Also, you MUST forward backup documentation and the student's 8 digit Foothill ID number (SID) to the Dean of Student Affairs or no action will be taken. If all the information is provided, the reports will be placed in the student's file. No action will be taken unless the instructor has selected "proven." Again, it is critical that you report ALL cases, as accumulated "suspected" cases by multiple instructors for a given student can assist the Dean of Student Affairs and Division Deans in identifying patterns and resolving cases. Please use this form to report one academic dishonesty violation at a time. Thank you. Student Name: Student ID number: (8 digits, use no dashes) Quarter: Summer Fall Winter Spring Academic Year: In Course ID (include section): Occurrence of offense in THIS course: First Second Third Follow-Up with Student? (Check ALL that apply) I have NOT contacted the student yet (Verbal) Spoke to student in person (Verbal) Spoke to student by telephone (Written) Via US Mail (Written) Via E-mail Proven violation? Circumstantial evidence (no hard evidence to prove it) Proven (have data and evidence to prove it) Description of Violation: (be as specific as possible) Action Taken by Instructor: (be as specific as possible) IMPORTANT: In addition to submitting this form, you MUST forward the material (evidence) that demonstrates your allegation to Dean of Student Affairs. Without this information, he cannot adequately speak with the student about the reported allegation. Include a phone number to contact you for verification. If you have any questions, or to confirm that the form arrived at the Office of Student Affairs, please call Bill Frankeberger at x7241. Instructor's Name: Phone number: E-mail: Email Report To My Dean: Select Division Dean/VP..... Bio & Health Division, Dean Eloise Orrell BSS Division, John Mummert CNSL Division, Donald Dorsey, VP CTIS Division, Tim Woods Fine Arts Division, Duncan Graham Language Arts Division, Dean Paul Starer Library Division, Richard Galope Phys. Ed. Division, Sue Gatlin PSME Division, Peter Murray Spec Ed Division, Gertrude Gregorio Upon submission, the report will be sent to the Dean of Student Affairs, your Division Dean or VP, and you (for your records). Thank you! top of page
Please complete the following form to report proven or suspected cases of academic dishonestly.
It is very important that you report all cases, even if you have handled them. Also, you MUST forward backup documentation and the student's 8 digit Foothill ID number (SID) to the Dean of Student Affairs or no action will be taken. If all the information is provided, the reports will be placed in the student's file. No action will be taken unless the instructor has selected "proven." Again, it is critical that you report ALL cases, as accumulated "suspected" cases by multiple instructors for a given student can assist the Dean of Student Affairs and Division Deans in identifying patterns and resolving cases. Please use this form to report one academic dishonesty violation at a time. Thank you.
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