University of sunderland

Collaborative Partner Interviewer’s comments on allegation:

Student’s comments on allegation including any mitigating factors:

Section A – the matter is less than serious and has been dealt with by agreement with the student under the Stage 1 regulations  Code for offence :  Penalty imposed :  Rationale / Mitigating circumstances if relevant (essential if penalty is reduced):  Signed: Print Name:

Student’s Comments on outcome: (Student to circle the answers as appropriate)  I acknowledge that the tutor above has informed me of his/her suspicion of academic misconduct under the University’s Regulations, with regard to an assessment in the above module, and I:  AGREE DISAGREE  that I have breached the University’s Academic Misconduct Regulations. If the tutor considers the misconduct to be less than serious I have agreed that the matter may be addressed by way or minor penalty, but acknowledge that the Academic Misconduct Panel and Assessment Board have the right to vary this penalty, particularly where information is available to the Panel and Board not known to the tutor. I understand that any penalty agreed is subject to a review of my academic transcript and that the penalty may be increased if my record shows any previous incidence of academic misconduct. I am aware that having agreed to the penalty I have the right to appeal that penalty within ten working days, and that the guidance notes and appeal form are available in the University’s online guidance pages at:  https://services.sunderland.ac.uk/academicregistry/academicqualityhandbook/studentcasework/#appeals AGREE DISAGREE