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Social Security Number Violation Report Form

In accordance with Policy Statement 113, Social Security numbers are to no longer be used for grading purposes in the classroom.  By submitting the form below, Student Government will contact the appropriate administrator to ensure that future usage of the SSN does not occur.

 

 

Student Information

 

This information will remain confidential unless you choose to allow for its release.  All requested contact information is REQUIRED, though, in the event that we need to contact you for more information about the violation.  *Required Field

 

First Name                              Last Name

       

 

Email (Required)                      Classification

       

 

Student ID Number (found on Tiger Card; NOT your SSN)

 

Do you wish to remain anonymous in the final report?

 

 

Course Information

 

Course Prefix                         Course Number

       

 

Section Number                     Instructor

       

 

Course Title

 

 

Description of the Violation

 


 

 

"I certify that all of the information that I have given in this form is true and correct."

Your Initials

 

Date

 

 

 

 

 

For more information, contact the LSU Student Government Director of Academics at sg@lsu.edu or 578-8727.