Disqualification Incident Report

Disqualification Incident

Please indicate with a check mark which of the infractions is believed to have occurred. You may select more than one.*

Students must not be in possession of or have used any secure materials prior to the session
Students must not communicate with other students.
Students must not give or receive assistance of any kind in answering a question, including allowing their work to be viewed by others or copying answers from another student’s work.
Students must not possess any book, paper or item that might assist in writing an assessment, including a dictionary or piece of electronic equipment that is not specifically authorized for the assessment.
Students must not copy, plagiarize or present as their own, work done by any other person.
Students must immediately follow the invigilator’s order to stop writing at the end of the session time and must not alter the Response Form after the invigilator has asked students to hand them in.
Students must not remove any piece of the assessment materials from the assessment room, including work pages.
Students must not navigate outside the screen for any reason including accessing any materials on the local computer or internet.

Were all the infractions listed above reviewed with the student prior to the start of the assessment?*

Yes
No

Please provide a reason*

When was the alleged disqualification incident discussed with the student?*

Please outline the details of the alleged disqualification incident that occurred. Please feel free to include a rough sketch of the room setup and placement of individuals involved in the alleged incident if helpful.*

Please submit copies of any supporting documentation if it exists (e.g. any written materials the student may have brought into the room). Retain the original for your files.

Drop files here or

Max. file size: 32 MB.

Has the student been given the opportunity to respond?*

See student’s written response
The student has chosen not to respond in writing

Upload Student's Written Response

Drop files here or

Max. file size: 32 MB.

Step 1 of 3

Student Identification Information

Disqualification Incident

Completion of the following section is required