Forms & Templates

The Academic Integrity Office has developed templates for students and faculty to use when communicating with one another or with the Academic Integrity office about a suspected violation and/or academic misconduct decisions. To ensure all required pieces of information are included in communications, it is recommended that students and faculty use these templates. Copy the Academic Integrity Office ( on all communications related to academic misconduct.

Meeting request

Use this template to schedule a meeting with a student to discuss an issue of academic integrity. Copy the Academic Integrity office on the meeting request ( If you intend to have an observer attend the meeting, include their name and role in the meeting request. (Contact to learn more about having an observer attend the meeting.) 

Dear [student’s name]:

I am writing in regard to the [piece of work] that you submitted on [date] for [course]. I am concerned there may be a violation of MacEwan University’s Academic Integrity Policy in this piece of work. [Give more specific details of your concern. e.g. Specifically, I am concerned there may be an act of plagiarism on the third page.]

I would like to meet with you to discuss my concern. I have scheduled an appointment for [date, time, location]. If you are unable to attend this appointment, please reschedule by [date]. I will be making an appropriate decision regarding any further action after this date.

If you would like to have a support person attend the meeting with you, you can find out more about that option by contacting SAMU's Student Advocacy Office

[Instructor's Name
Contact information]

Notification: No violation

If an instructor decides, after meeting with a suspected student, that the Academic Integrity policy has not been violated, that decision needs to be communicated to the student. The Academic Integrity Office has prepared the following template to ensure instructors communicate all of the necessary information to the student.

Dear [student’s name]:
I am writing in regard to the [piece of work] that you submitted on [date] for [course]. After meeting with you, my assessment is that this [piece of work] does not involve a breach of the Academic Integrity Policy. [Give brief explanation of your decision.]
The Academic Integrity Office will delete records related to this investigation.
[Instructor name
Contact Information]

Student request for a review hearing

If a student disagrees with an instructor's decision that academic misconduct has occurred they can request an appeal by sending an email to the Academic Integrity Office. The appeal request will lead to a Review Hearing.

Dear Academic Integrity Coordinator:

I am writing to request a Review Hearing in regard to the [piece of work], which I submitted on [date] for [course]. [Instructor's name] has concluded that this [piece of work] involves a violation of MacEwan University's Academic Integrity Policy. My instructor has imposed a penalty of [specify penalty] for [specify the violation eg. plagiarism, cheating, etc.].

I am appealing the decision that academic misconduct occurred on the grounds that [explain your reasons]. I am asking that [explain your expected outcome of the Review Hearing].


[Student’s Name]


Incident report form

Use this form to report an academic integrity violation. File this report only after the student has been given an opportunity to meet with the instructor and a policy violation has been confirmed.

Note: You must be logged out of any personal Google accounts to access the form.

Incident report form