STUDENT JUDICIAL COMPLAINT FORM
Completed form should be sent to: Student & Instructional Support Services (DSI)
Name of Complainant:
Name of Accused:
Accused’s Student ID#: Accused’s Phone #:
Date of Incident: Time:
Course (if applicable): Campus/Location:
Brief Description of Incident (attach additional sheets as needed):
Standard of Conduct Sections(s) Violated:
(See Student Handbook for section numbers)
Is this a violation of academic integrity (10.00 – 10.08)? Yes No
If “yes”, please complete sides 1 and 2 of this form. If “no”, only complete side 1.
Questions? Call DSI at 301- 934-7509
Signature of Complainant: Date:
Daytime Phone Number: Email Address:
For Office Use Only:
Received by: Date Received: Case Number:
Investigator: Committee or Hearing Officer:
Hearing Date: Decision: Sanction:
ACADEMIC INTEGRITY VIOLATIONS (Student Handbook: 10:00 – 10:08)
A faculty member should follow these steps:
Step 1: Fill out side 1 of the Student Judicial Complaint Form.
Step 2: Meet with the student to explain why you think the student committed a violation of our standards
for academic integrity. Provide the student with an opportunity to discuss the situation.
Step 3: If, after discussing the situation with the student, you are convinced that the student has
committed a violation, inform the student that you will be assigning him/her a grade based on the
violation and will be forwarding the information to the Vice President of Student and
Instructional Support Services. The faculty member shall, at a minimum, assign the student a “0”
or its equivalent on the paper, examination, or presentation in question.
Step 4: Inform the student of the process to appeal a grade (see Student Handbook).
Step 5: Completed side 2 of the Student Judicial Complaint Form and submit it.
Second Offence – If the student has previously been found to have violated the standards for
academic integrity, the faculty member will be notified by the Vice President of Student and
Instructional Support Services and will be requested to assign the student an “F” grade for the
course. The student will be issued a Letter of Warning and, absent a successful grade appeal, will
be barred from further class participation. The “F” may not be changed to a “W” for any reason.
Third Offence – If the student has been found to have violated the standards for academic
integrity two or more times previously, then the faculty member will be notified that a Student
Conduct hearing will be held. If the Student Conduct Board (or Student Conduct Administrator)
determines that the student has violated the academic integrity standards, the Student Conduct
Administrator will notify the student that he or she will receive an automatic “F” for the course
and will be immediately suspended from the college for one or more semesters as deemed
appropriate by the Student Conduct Administrator. The “F” may not be changed to a “W” for any
Did a student/instructor conference take place? Yes No
If “yes”, Please describe results/sanction:
Was the student informed about the appeal process? Yes No
For Office Use Only:
First Offense: Second Offense: Other:
Hearing Held: Yes No Hearing Date: Decision:
Letter of Warning: Mandatory “F”: Suspended from College: (thru )
Appealed: Yes No Result: