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Academic Honesty Referral (AHR) Form


Academic Honesty means that students' work represents their own personal abilities and original thinking. Student work should be completed without plagiarism, cheating, unsanctioned use of AI programs, or other unethical or dishonest behaviors. Refer to the Academic Policy and Procedure ISP 190 and ISP 190P for more details and additional steps on how to respond to academic misconduct. The purpose of this form is to record incidents of academic dishonesty for future or concurrent reference, to store documents related to said incidents as needed, and to notify the CARE team if further action is recommended. The data gathered from this form is accessible to the CARE team only and is used solely to address issues in student learning. CCC takes Academic Honesty seriously as an issue of student learning and success; if a student is engaging in these behaviors persistently, they are not benefiting from their education at CCC. 

Because student success is the end goal of education, please contact the student directly before using this form whenever feasible (though this may depend on the timing of the incident). The AHR form is not a replacement for the interaction between student and instructor which is the heart of learning.  For resources on how to approach academic honesty as a learning opportunity, refer to the folder from the Center for Teaching and Learning called "Academic Honesty Resources for Instructors".

Reporter's Information

 
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Student(s) Involved

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Questions

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Actions taken by instructor (please mark all that apply):(Required)
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Did the student mention any of these underlying factors as an explanation for their academic dishonesty?(Required)
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Supporting Documentation

For record-keeping (in case of contested grades) and/or referral (in case of concurrent or future incidents), please upload any supporting documents and evidence here. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Submission