Honor Council Peer Counseling Referral
Email address *
Today's date *
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Student's Name *
Your answer
Student's Grade
Date of Offense *
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Describe the student's offense. *
Your answer
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.)
Your answer
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.)
Your answer
What is your desired outcome of this student's meeting with the Honor Council? *
Your answer
Signature *
Please type your name as your signature.
Your answer
A copy of your responses will be emailed to the address you provided.
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