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.
Can you demonstrate through documented evidence that the misconduct did not occur as was determined by the course Instructor?
Did you contact your instructor in writing within three (3) days of notification from your instructor of the alleged violation and penalty?
Have you heard back from your instructor about this incident?
Supporting Documentation
Please provide any supporting documentation.

Cancelof
Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

Student Information