Academic Integrity Violation Appeal Form

Academic Integrity Violation Appeal Form

Level 1: Academic Dean/Director
Students who receive an academic sanction for violating the “Academic Honesty and Integrity” policy may appeal the sanction using the following form within five (5) business days of notification of the sanction from the faculty member. A business day is defined as Monday - Friday, 8:00 a.m. to 5:00 p.m., excluding Federal Holidays and official RPCC closure days.  Note: When RPCC is open, but classes are not in session, it will be considered a business day. 
Student Information
Name of Student*

First NameLast Name
Student ID number (LOLA Number)*
Student's RPCC email address*
example@students.rpcc.edu

Incident Information
Describe the incident and provide your justification for why the appeal should be approved.*
YesNo
YesNo
YesNo
Supporting Documentation
Please provide any supporting documentation.*

Cancelof
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

Student Information