Informal Academic Misconduct Reporting
Welcome to the UM-Dearborn Informal Academic Incident Report form.  Please Note this form is only for Informal Academic Integrity cases. This report will not be stored in the University's Record Database, but will be used to track if students are eligible for the informal process. Informal Academic Misconduct can be utilized when a faculty wishes to resolve misconduct at a classroom level and the student has accepted responsibility and agreed upon restorative measures. Students are only eligible for a maximum of two (2) informal violations.


If you wish to file a Formal Academic Integrity report please visit this site: https://umdearborn-advocate.symplicity.com/public_report/index.php/pid129200?

Please provide as much detail about the incident as possible.
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Email *
Reporter Type & Information
Please indicate your relationship to University of Michigan-Dearborn below
I am a *
Name *
Phone Number *
Academic Integrity
*Please note that students will receive a copy of the report submitted.

Academic Code of Conduct Violation Report Information
When a faculty member determines that a student has violated the University’s Academic Code of Conduct (ACC), they shall complete this form. Upon submission, the Associate Dean of the college of the report will be notified automatically. The purpose of the reporting is to help the University identify and sanction the offenders who repeatedly violate the ACC.
College that the academic misconduct occurred in? *
Course *
Please write out the subject rather than using acronyms (e.g. Biology 201).
Term *
Please enter the term and year that this course was held (e.g. Fall 2010).
Violations

The actions cited as prohibited conduct should be used as a guide rather than an exhaustive list of behaviors that the University considers misconduct and subject to disciplinary action.

Plagiarism: includes representing the words, ideas, or work of others as one’s own in writing or presentations, and failing to give full and proper credit to the original source. Failing to properly acknowledge and cite language from another source, including paraphrased text. Failing to properly cite any ideas, images, technical work, creative content, or other material taken from published or unpublished sources in any medium, including online material or oral presentations, and including the author’s own previous work.

Cheating: includes copying from another’s exam or other evaluative assignment. Using notes, books, digital devices or resources, or other materials for an exam or other evaluative assignment without explicit permission of the instructor. Submitting work that was previously used for another class without the informed permission of the instructor. Discussing or sharing information about questions or answers on an exam or other evaluative assignment without explicit permission of the instructor. Giving, taking, or receiving a copy of an exam without explicit permission of the instructor. Allowing another person to take an exam or complete an assignment for the student. Attempting to change the result of an exam or other evaluation.

Fabrication: includes alterations to transcripts, grades, letters of recommendation, or other evaluations by or for any current or former student.

Aiding and Abetting Dishonesty: altering documents affecting academic records; aiding others to commit any act prohibited by the ACC; forging a signature of authorization or falsifying information on an official academic document, election form, grade report, letter of permission, petition, or any document designed to meet or exempt a student from an established University or unit academic regulation.

Interference: obstructing or hindering the work or study of a member of the faculty, or staff, or a student at the University.
Please select all that apply. *
Required
Restorative Measures Imposed *
Briefly describe the restorative measures (sanctions) imposed.
Date student was informed of charges *
Per the Academic Code of Conduct, the faculty member shall inform the student of the nature of the ACC charges; explain the sanctions imposed as a result of the charges; and provide him/her an opportunity to refute the allegations. If the faculty member is unable to meet with the student to discuss the charges please indicate the alternative method of communication.
Academic Integrity Students Involved
Was the student notified about the report being filed? *
Was the student offered the opportunity to meet privately to discuss this matter? *
Did the student attend the meeting to discuss the matter? *
Students Involved Information
Please include each students name accompanied by their UM ID and Uniqname.  
Date of Incident
MM
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DD
/
YYYY
Time of Incident *
Time
:
Location of Incident *
Please provide as much detail about the location of this incident as possible.
Descriptive Information *
Please provide as much information as possible about the incident.
A copy of your responses will be emailed to the address you provided.
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