Appendix 2: Sample Academic Integrity Checklist

Course code: ___________________________________________________________________
Assignment title: ________________________________________________________________
Instructor’s name: ________________________________________________________________

I, _______________________________, affirm that this assignment represents entirely my own efforts.

I confirm that:

__ I have acknowledged the use of another’s ideas with accurate citations.
__ If I used the words of another (e.g., author, instructor, information source), I have acknowledged this with quotation marks (or appropriate indentation) and proper citation.
__ When paraphrasing the work of others, I put the idea into my own words and did not just change a few words or rearrange the sentence structure
__ I have checked my work against my notes to be sure I have correctly referenced all direct quotes or borrowed ideas.
__ My bibliography includes only the sources used to complete this assignment.
__ This is the first time I have submitted this assignment (in whole or in part) for credit.
__ Any proofreading by another was limited to indicating areas of concern which I then corrected myself.
__ This is the final version of my assignment and not a draft.
__ I have kept my work to myself and did not share answers/content with others, unless otherwise directed by my instructor.
__ I understand the consequences of violating the University’s Academic Integrity policies as outlined in the Code of Behaviour on Academic Matters.

By submitting this form, I agree that the statements above are true. If I do not agree with the statements above, I will not submit my assignment and will consult the course instructor immediately.

Student name: __________________________________________________
Signature: ______________________________________________________
Date: __________________________________________________________