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CORPORAL PUNISHMENT FORM
Please submit one form for each student
HOOKER BOARD OF EDUCATION
Date
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Month
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Day
Year
Date
Student Name
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First Name
Last Name
Grade
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Pre-K
K
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I GIVE MY PERMISSION for the above named student to receive corporal punishment. Corporal punishment will be only administered after other reasonable corrective measures have been used. Only an administrator will administer corporal punishment while witnessed by certified personnel. The corporal punishment will only be administered in a school office out of the presence of other students. Careful documentation of each occasion shall be made by the administrator. Such documentation will identify the student, the person who administered the punishment, and the name of the witness. It will also describe the behavior necessitating the punishment. The student shall be advised of the nature of the rule infraction for which the punishment is being administered. No more than three (3) swats will be administered per school day. The swats will be administered with reasonable force by a wooden paddle on the buttock’s area of the student. The appropriate office will make every effort to notify the parent/legal guardian by phone prior to the above named student receiving corporal punishment.
I DO GIVE PERMISSION
I DO NOT GIVE PERMISSION for the above named student to receive corporal punishment.
I DO NOT GIVE PERMISSION
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