This form is to be completed when an individual(s) allegedly violates the MCHP Student Code of Conduct. A form must be completed for everyone who allegedly violates the Student Code of Conduct.
Student’s Name: _________________________________
Date: _________________________________
Student’s Program of Study: _________________________________
Program Dean: _________________________________
Describe the alleged student Code of Conduct Violation: _________________________________
_________________________________
_________________________________
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Attach supportive evidence
Meeting with the Program Dean
Date the Program Dean was Notified: _________________________________
Signature: _________________________________
Date of Meeting Scheduled with Individual who Allegedly Violated the Student Code of Conduct: _________________________________
Signature of the Program Dean: _________________________________
Signature of the Student: _________________________________
Results:
- The student is not responsible and/or violated the Student Code of Conduct.
- No action is required
- The student is responsible and/or violated the Student Code of Conduct.
- Disciplinary Action(s): _________________________________
- Remediation: _________________________________
Appeal the Program Dean’s Decision
√ The student wishes to appeal the program dean’s position and will submit all evidence and this form to the CAO.
√ The student does not wish to appeal the program dean’s decision.
The student must submit their appeal to the CAO within five (5) business days of the decision of the program dean, or the decision of the program dean is final, and no appeal will be accepted.
Decision of the Code of Conduct Committee
√ Substantiated: the committee found enough evidence that supports the student violated the MCHP SCC.
√ Unsubstantiated: the committee did not find enough evidence that supports the student violated the MCHP SCC.
The committee’s decision is final