Behavior Causing Concern in the Classroom or Administrative Offices Form

It is a violation of the CSCU Student Code of Conduct for students to exhibit inappropriate behavior in the classroom or at any administrative office. This includes the non-traditional classroom settings. Faculty and administrators are encouraged to use the below form for incidents that involve disruption or obstruction of teaching, research or other academic or administrative activities, forgery, plagiarism, etc.. Please send this form to the Director of Judicial Affairs, Midtown Student Center 220.

Incident Information

Faculty/Administrator's Name/Department:

Faculty/Administrator's Extension:

Date of Incident

Time of Incident

Course/Location

Name of Student

Student ID #

Please write a narrative of the inappropriate behavior and the intervention that may have happened in your classroom or office between yourself and the student(s).

Date that Professor/Administrator...

Sent form to Director of Judicial Affairs:

Spoke to and informed student that a complaint has been filed:

Professor/Administrator Signature

For office use only

Director of Judicial Affairs Received on:

Director of Judicial Affairs Spoke to Professor/Administrator on:

Student(s) on:

Case closed on:

Contact Information