Honor Council Peer Counseling Referral
Email address *
Date of Referral *
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Student's Name *
Student's Grade
Date of Offense *
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Describe the Offense *
Have you discussed the offense with the student? *
Required
If yes, have you made any agreement with the student regarding his/her decision to meet with the Honor Council? Please explain.
Ex., an opportunity to redo the assignment, partial credit, no disciplinary referral, etc.)
Please add any additional information you would like to share.
Ex., previous concerns involving this student's academic honesty or the student's response if/when you discussed the concern.)
What is your desired outcome of this student's meeting with the Honor Council? *
Your Signature (electronic) *
Please type your name as your signature.
A copy of your responses will be emailed to the address you provided.
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