UNDERGRADUATE ACADEMIC
ETHICS BOARD
Stipulation of Facts and Settlement Agreement
INFORMATION:
This form serves as an official stipulation of facts and
settlement agreement for use by the Undergraduate Academic Ethics Board of
the Johns Hopkins University. Submission of this form assumes that all
parties agree to both the facts of the case and the penalty or penalties
imposed by the professor.
A charge of academic misconduct may only be settled between the
professor and student(s) if (1) the student(s) involved have no prior
record of academic misconduct AND (2) the penalty or penalties imposed are
selected from items (b) through (e) of Article VII of the Constitution of
the Undergraduate Academic Ethics Board. It is the professor's
responsibility to check with the Office of Academic Advising to determine
whether the student(s) involved have a prior record of academic
misconduct. If either of the above conditions have not been met, the case
must be resolved by a hearing panel of the Ethics Board.
INSTRUCTIONS:
Please complete all items contained in this form. Include copies
of any relevant documents. It is
advisable that you retain copies of this and all documents relevant to
this case. Any questions may be directed to the above address or via
email to ethicsbd@jhunix.hcf.jhu.edu. Please type or print legibly.
Undergraduate Academic Ethics Board
Stipulation of Facts and Settlement Agreement
I. Stipulation of Facts
1. Name, title, and campus phone number of faculty member bringing
charges:
2. Name(s) of student(s) guilty of academic misconduct:
3. List the course name, number, and section (if applicable) in which the
misconduct occurred. List also the semester in which the course was
taught.
4. Indicate the academic exercise(s) associated with the academic
misconduct (ie., examination 3, second paper, etc.).
5. Indicate specifically the type of offense which occurred. If more
than one student is involved, list each individually.
(ex: John Doe- cheated on closed book exam by using crib notes)
6. Please describe the circumstances of the academic misconduct. Use the
reverse side of this sheet if necessary.
II. PENALTY/ PENALTIES
Describe the penalty/ penalties to be imposed. Use the reverse side
of this sheet if necessary.
III. SIGNATURES
All parties must sign below indicating they (1) understand and
agree to all information contained herein, and (2) understand and agree to
the penalty/ penalties imposed. If more than two students are involved,
sign on the reverse side of this sheet.
__________________________ ______________________ __________
Faculty member signature Print name
Date
__________________________ ______________________ __________
Student signature Print name
Date
__________________________ ______________________ __________
Student signature Print Name Date