NHHS Staff Academic Integrity Infraction Reporting Form This form is being used for the collection of data. Submission of this form is anonymous and there will be no disciplinary action as a result of anything reported through this form. Question Title * 1. What was the date of the incident? The incident occured on: Date Question Title * 2. In what department/location did the infraction occur? Art Business English Family & Consumer Science Math Media Center(Library) Music Physical Education Science Social Studies Special Education Technology Education World Language Other Other (please specify) Question Title * 3. What is the grade level of the student(s) involved in incident: 9 10 11 12 Mixed Unknown Question Title * 4. What is the level of the course in which the incident occured? (Select all that apply) AP Honors CP Core Practical Art Elective Fine Art Elective Academic Required Course Academic Elective Incident Did Not Occur in a Class Question Title * 5. Type of Infraction/Method Cheating on test: vocabulary/terminology Cheating on test: scantron Cheating on test: in-class essay Cheating on test: open-ended/short answer Cheating on test: take home essay Cheating on test: take home test Cheating on quiz Homework Lab Research Sharing or getting answers online Sharing or getting answers from other students in school Other (please specify) Question Title * 6. Are you going to pursue action? Yes No Question Title * 7. If yes, what type of action did/will you pursue? (select all that apply) Administrative action Parent contact Speak with student Classroom action such as points off, zero, etc. Other (please specify) Done