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Student AI Disclosure Form

The Student AI Disclosure Form is designed for students to disclose the use of AI tools in their assignments. It includes sections for indicating whether AI was used, specifying the tools and level of assistance, and providing explanations for the AI's role in the assignment. The form must be completed and attached to the assignment, following instructor guidelines.

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Jay-Justin Rose
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0% found this document useful (0 votes)
181 views2 pages

Student AI Disclosure Form

The Student AI Disclosure Form is designed for students to disclose the use of AI tools in their assignments. It includes sections for indicating whether AI was used, specifying the tools and level of assistance, and providing explanations for the AI's role in the assignment. The form must be completed and attached to the assignment, following instructor guidelines.

Uploaded by

Jay-Justin Rose
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Appendix A

Student AI Disclosure Form1


Name: Click or tap here to enter text.
Date: Click or tap here to enter text.

Have any AI tools been used in the creation of this report/ assign-
ment?
☐No ☐Yes
If no, please sign below

Instructions: Select the appropriate tool(s) and use(s) of AI for your assignment. Note that you may only use AI as
permitted, so please follow all the instructions provided by your instructor. Attach the completed form to your assign-
ment. Contact your instructor if you have questions.
Tool(s) Used: ☐ OpenAI ChatGPT ☐ Microsoft Copilot ☐ Google Gemini ☐ Anthropic Claude ☐Per-

plexity ☐ DALL-E 2 ☐ AI Art Generator ☐

☐ Other: Click or tap here to enter text.


Indicate below the level of AI used in your assignment. Your instructor will specify which option(s) are permitted.

No AI AI as a Study Tool (AI Used as a Study


This lane ensures that your work reflects your own un- Companion or Tutor)
derstanding and aligns with course outcomes without ☐No AI assistance
the use of AI tools (e.g., in-class discussions, written doc-
uments, quizzes, tests, and invigilated exams). ☐Minimal AI assistance (e.g., preparing review materials)
☐Moderate AI assistance (e.g., used as a supportive tutor
☐ No AI assistance or study companion)
☐Significant AI assistance (e.g., collaborated with other
students to create study guides and personalized tutor
sessions)

1
This form was adopted from an open-source AI and modified by the University of Technology, Jamaica
Approved by the Academic Board at its meeting held May 22, 2025 – Ref Paper 2025/A/05/47G
Approved by the GSREC at its meeting held April 17, 2025 – Ref Paper 2025/GSREC/04/16
Approved by the USC at its meeting held March 19, 2025 – Ref Paper 2025/USC/03/13

Page 10 of 11
AI for Idea Generation (AI Used to Enhance Brain-
AI as Editor (AI Provides Feedback for Improve-
storming)
ment)
☐No AI assistance
☐No AI assistance
☐Minimal AI assistance (e.g., initial brainstorming)
☐Minimal AI assistance (e.g., identifying grammar and
☐Moderate AI assistance (e.g., generating the structure of spelling errors)
the assignment)
☐Moderate AI assistance (e.g., applying style suggestions)
☐Significant AI assistance (e.g., expanding on initial
☐Significant AI assistance (e.g., making content enhance-
thoughts, generating draft copy, code, image, music, or
ments or comprehensive edits)
artwork)

This section requires AI use as part of the assignment, so "no AI assistance" is not an option.

AI as Output Evaluated (AI Results are Critically Evalu- Full AI (AI is Integral to Assessment)
ated)
☐Minimal AI assistance (e.g., used as an assistant to or-
☐Minimal AI assistance (e.g., evaluation of outlines or ini- ganize thoughts and integrate various viewpoints)
tial research)
☐Moderate AI assistance (e.g., used to draft an outline,
☐Moderate AI assistance (e.g., evaluation of summaries or
suggest a structure, or provide initial content to build on
first drafts)
and refine)
☐Significant AI assistance (e.g., evaluation of final draft)
☐Significant AI assistance (e.g., used to generate a sum-
mary from group discussion, collate research findings
into a report)

Explanation:
In the table below, describe the ways you used AI:

What prompt did you provide? Click or tap here to enter text.

What did you use the tool for? Click or tap here to enter text.

How have you used or changed the generative Click or tap here to enter text.
AI’s output?

Where provided, please upload the transcript from the AI tool.

Approved by the Academic Board at its meeting held May 22, 2025 – Ref Paper 2025/A/05/47G
Approved by the GSREC at its meeting held April 17, 2025 – Ref Paper 2025/GSREC/04/16
Approved by the USC at its meeting held March 19, 2025 – Ref Paper 2025/USC/03/13

Page 11 of 11

Common questions

Powered by AI

The document advises students to contact their instructors if they have questions regarding the acceptable use of AI tools in their assignments. This approach ensures that students understand the specific guidelines and permissions regarding AI usage within their courses .

AI use is considered 'full' when it is integral to the assessment itself. This includes minimal assistance for organizing thoughts and integrating various viewpoints, moderate assistance for drafting outlines and suggesting structures, and significant assistance for generating summaries from discussions or collating research findings. The criteria focus on how extensive AI involvement is in creating and evaluating the content .

The document outlines several levels of AI assistance for student assignments: No AI, AI as a Study Tool, AI for Idea Generation, AI as Editor, AI as Output Evaluated, and Full AI. Each level specifies different scopes of use. 'No AI' means no aid from AI tools, ensuring personal understanding and alignment with course outcomes. 'AI as a Study Tool' includes using AI minimally for preparing review materials, moderately as a supportive tutor, or significantly with peers for creating study guides. 'AI for Idea Generation' involves minimal use for brainstorming, moderate for assignment structure, or significant assistance for expanding thoughts or creating drafts. 'AI as Editor' ranges from identifying errors to style suggestions, requiring comprehensive edits. For 'AI as Output Evaluated,' minimal to significant AI assistance is used in evaluating drafts. 'Full AI' involves AI as an integral part of the assessment process, from organizing thoughts to generating summaries .

Students are responsible for accurately documenting the AI tools used, the level and purpose of AI assistance, and ensuring that their use complies with the guidelines set by their instructor. This involves stating how they have modified the AI's output and possibly uploading the transcript from the AI tool, to maintain academic integrity and transparency .

AI can be employed as a study tool with varying levels of assistance. Minimal assistance allows for preparing review materials. Moderate use involves AI as a supportive tutor, while significant assistance includes collaboration with other students to create study guides and conduct personalized tutor sessions. These approaches leverage AI to enhance the study experience while varying the depth of AI integration .

The document instructs students to select and document the specific AI tools used for assignments, specify the level of AI assistance, and describe the tasks for which AI was utilized. Students must also provide the AI prompts used and upload the AI tool transcript if available, ensuring detailed accountability and transparency in their work .

AI assistance used minimally as an editor involves identifying grammar and spelling errors. When used moderately, it applies style suggestions to the textual content. Significant AI assistance encompasses making content enhancements and comprehensive edits, requiring deeper involvement and changes in the text .

Disclosing AI use in academic settings is significant because it ensures transparency in how student work is produced and the extent of AI involvement. It helps educators understand the student's personal grasp of the subject against the aiding role of AI tools. The disclosure is also crucial for aligning with course outcomes and ethical adherence to academic standards .

The document mandates that 'no AI assistance' is not an option in the AI as Editor section because utilizing AI tools for editing is considered essential for assignments in this context. This requirement likely stems from the expectation that editing, as a technical aspect, benefits from AI's precision in identifying errors and enhancing style, thereby standardizing and possibly improving the quality and consistency of academic submissions .

For AI in brainstorming, minimal assistance involves initial idea generation, moderate helps in structuring assignments, and significant expands initial thoughts and drafts or creates creative content. In contrast, AI as an editor with minimal assistance is limited to grammar correction, moderate includes stylistic edits, and significant involves comprehensive content enhancements. Both roles use varying AI engagement levels tailored to the particularity of the task—creative thought generation versus refinement of existing content .

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