Academic Integrity Appeal Form

Appeal a sanction imposed pursuant to this Policy to the Student Academic Integrity Appeals Committee.

Student Information:

Student Name(Required)

First Last

Student ID(Required)

Contact Information During the Term

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Phone(Required)

Email(Required)

Contact Information Outside of the Academic Year

Please note that an appeal may not be complete before the end of term.

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Details of Decision You Are Appealing (Course Information)

Department(Required)

Course Number and Section(Required)

Term(Required)

Instructor Name(Required)

Grounds for Appeal

Appealing on the basis of:(Required)

an error of fact

an error of process

sanction was inappropriate

The grounds for appeal are described in Carleton’s Academic Integrity Policy. Please indicate the reason(s) for your appeal by checking the appropriate box(es) below.

Please provide a concise statement that identifies precisely the grounds for the appeal. For example, if you checked "error of fact" above, then you would provide an explanation what error of fact occured. Students are advised to consult either with the Ombudsperson or the Director, Student Affairs for assistance in completing this appeal documentation.(Required)

Relief Requested

What relief do you want from the Senate Student Academic Integrity Appeals Committee?(Required)

Request for Oral Hearing (optional)

The Senate Student Academic Integrity Appeals Committee (SSAIAC) 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.

Do you have a preference for either a written or oral hearing?(Required)

Oral (even if it is requested, it may not be granted, so please ensure your written submission is complete and addresses all the bases for your appeal.)

Written

If you requested an oral hearing above, please explain why. An oral hearing is held only where the Committee concludes that written submissions cannot provide an adequate basis for assessing the issues in appeal. Please explain why you believe a decision cannot be made on the basis of written submissions.(Required)

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.

If you are close to graduating, does the outcome of this appeal have the potential to impact your graduation plans within the next 3 months?(Required)

Yes

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.

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