• Student Information:

  • Contact Information During Term:

  • Contact Information Outside Academic Year:

    Please note that appeal may not be complete before the end of term.
  • Details of Decision You Are Appealing (Course Information):

  • Grounds For Appeal:

    The grounds for appeal are described in Carleton's Academic Integrity Policy. Please indicate the reason(s) for your appeal by putting an checking in the appropriate box(es) below.
  • Relief requested:

  • Request for an oral hearing (optional):

    The Senate Student Academic Integrity Appeals Committee holds both written and oral hearings. The Carleton Academic Integrity Policy explains when an oral hearing is necessary. The SSAIAC procedures explain how an oral hearing is conducted.
  • Please note: The Senate Academic Integrity Appeal Committee reserves the right to choose the format of the appeal hearing. Preference for an oral hearing does not mean that an oral hearing will automatically occur.
  • A copy of the application will be forwarded to the Senate Student Academic Integrity Appeal Committee. The Committee may also forward a copy of the application to the person who made the original decision on your case.
  • The personal information requested on this form is collected in accordance with Sections 38(2) and 41(1) of the Freedom of Information and Protection of Privacy Act (FIPPA),R.S.O. 1990, c.F.31 as amended. The information provided will not be used for any purposes other than those stated upon this form unless the applicant provides express written consent. Should you have any questions concerning your personal information, please contact Robert Moher, FIPPA representative for Carleton University (607 Robertson Hall, 613-520-2600 ext. 2047). Carleton University is fully compliant with FIPPA and endeavours at all times to treat your personal information in accordance with this law.