Official Student Disciplinary Enquiry Form for PLAGIARISM

Please complete this form in full.
Incomplete forms will not be processed.
The original documentary evidence must accompany this form.
In the case of plagiarism we need: the original assignment and turn-it-in-report; a clear indication of where in the text plagiarism has allegedly been committed.

Keep a copy for your record and send the original form, together with all original supporting documents, via e-mail or by hand (do not send via internal mail) to the Student Disciplinary Office (contact details indicated above).
NB! One enquiry form per student.
NB! Take note that the report should be done by the School Director of the relevant school in terms of the Policy on Plagiarism.

In terms of the Protection of Personal Information Act 4 of 2013, this document and all supporting documentation must be handled as strictly confidential.

Compulsory fields

Campus

Date reported

Reported by:

Staff number:

Tel:

Email:

Student:

Student number

Module code:

School and Faculty:

Date of incident:

Has the paper been graded / marked?

Graded / marked by?

Has a grade been given?

If so, what is the grade?

Was the incident reported by the relevant lecturer to the School Director?

Did the lecturer confront the student with the allegation of plagiarism?

If this is the case, did the student present his or her version in respect of the allegation of plagiarism?

Did the lecturer make a recommendation to the School Director, that the student should be formally charged?

Did the School Director conduct a preliminary investigation into the alleged plagiarism?

Did the School Director compile a report on the preliminary investigation?

Please provide your written statement, as School Director, of the events in the designated space below or on a separate document.

This section is compulsory and is of great value to the Student Disciplinary Office in the execution of a fair enquiry and hearing procedure. Please follow these guidelines when formulating your written statement: (1) please identify yourself; (2) mention the transgression that has been committed; (3) mention time, place, circumstance; (4) if applicable, mention witnesses.

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Student Judicial Services

Official Student Disciplinary Enquiry Form for PLAGIARISM