by University Judicial Officer on_________________
to Student on_________________
to Department Chair on______________
to Dean on_______________
Faculty Member's Name:_________________________________ Ext:
Course Title:___________________________Semester and
Date(s) of faculty student meeting(s)_______________.
Description of the incident:
(Please copy and attach any necessary evidence)
The student has been informed of his/her rights as described in
the CCSU Student Handbook, including the right to pursue a grade appeal.
The student acknowledges a violation of Academic Honesty. --
The Professor's sanction:
Academic Conduct Workshop: