Course Number: _______________________________ Instructor: _______________________________ Type of Submission (Please check off reponses to both a & b) a. b. __ Report __ Assignment __ Lab Report __ Software
__ Individual submission
Having read both sides of this form, I certify that I/we have conformed to the Facultys expectations of originality and standards of academic integrity. Name: _______________________ ID No: __________
(please print clearly)
Signature: ___________________Date: ________ Signature: ___________________Date: ________ Signature: _________________ _ Date: ________ Signature: __________________ Date: ________ Signature: __________________ Date: ________ Signature: __________________ Date: ________
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Important: Should you require clarification on any of the above items please contact your instructor.