STUDENT INCIDENT REPORT

This form should be completed if disciplinary action is requested.

Date: 

Name of Person Completing Form:  

Email of Person Completing Form:  

Location of Incident:

Allen Center (AL)
Central Park Campus (CPC)
Collin Higher Education Center (CHEC)
Courtyard Campus (CYC)
Dual Credit, CPC1
Dual Credit, PRC2
Dual Credit, SCC3
Online/Blended Course, CPC
Online/Blended Course, PRC
Online/Blended Course, SCC
Preston Ridge Campus (PRC)
Rockwall Center (RW)
Spring Creek Campus (SCC)

Course Name & Section:

Student(s) Involved:

Name:   CWID:

Name:   CWID:

Name: 
 CWID:

Please refer to the Student Code of Conduct in the current student handbook (Chapter 2) and indicate the section(s) you believe have been violated. In cases of scholastic dishonesty please send documentation supporting the allegation(s), including internet addresses, to the appropriate Dean of Student Development Office.

Hold CTRL to select multiple violations

Describe Incident: Please include date, time, specific location (e.g. PRC F-109, SCC Atrium, etc.) and the names of any known witnesses.

1 Dual Credit, CPC includes the following schools: Anna High School, Blue Ridge High School, Community High School, Farmersville High School, McKinney Area Christian Home School, McKinney Boyd High School, McKinney Christian Academy, McKinney High School, McKinney North High School, Melissa High School, and Princeton High School.

2 Dual Credit, PRC includes the following schools: Carrollton Christian Academy, Celina High School, Centennial High School, Frisco High School, Hebron High School, Heritage High School, Liberty High School, Little Elm High School, Lone Star High School, Plano West High School, Prosper High School, The Colony High School, and Wakeland High School.

3 Dual Credit, SCC includes the following schools: Allen High School, Canyon Creek Christian Academy, Heritage Christian Academy, Lovejoy High School, Plano East Senior High School, Plano Senior High School, Rockwall High School, Rockwall-Heath High School, Royse City High School, Williams High School, Wylie East High School, and Wylie High School.

If you do not see a specific school in the lists above, please send the Student Incident Report to the campus at which your office is located.