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Urth Offence Date: Reported by: Nature of Offence: Discussed with Dean? How many hours of extra service should be completed? Has the extra service been completed on time? (within 7 days) yes Use supplementary sheet if necessary (In cases where a new course of action is being initiated please use a new form) The form should be filed in the student's file once filled in - see M. Salmon Student Discipline Form Student Name: Semester: Supplementary Sheet # Offence # Date: Reported by: N.

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