University of sunderland

Student Name:
Student ID no.:
Programme:		Module(s):
Collaborative Partner and Name of Interviewer:		Name of Module Leader:
Type of misconduct as described in the Penalty Table Appendix A :e.g. CW5		Date:
Minor Penalty dealt with by the Faculty at Stage 1: Yes / No If Yes, fill in section A for Stage 1 cases OR if No, fill in section B for Stage 2 cases  If Stage 1, please give the outcome overleaf and provide the student’s written agreement to the penalty. For Marking Adjustments please supply the original mark awarded and the adjusted mark:
Refer to Panel: YES / NO If yes you must submit Assessment & Evidence including the detailed interview form collated by the Independent Reviewer	Assessment attached [ ] (clearly annotated)		Supporting evidence attached [ ] (Turnitin originality report, website printouts, etc.)

Summary of Misconduct

In cases of suspected plagiarism, this must include commentary on why the evidence demonstrates plagiarism. Inclusion of the Turnitin report alone is not sufficient. Please remember that there is no ‘acceptable’ level, but you should however comment on the extent of the suspected plagiarism, its salience to the work as a whole and to specific aspects of that work. Please provide brief contextual information around the alleged offence eg if an exam, was it open book, if an assignment was there any groupwork element, was the purpose of the assignment to be diagnostic (eg early in the programme).