Brittan School Behavior Form

Brittan School Behavior Form
Name
Date

MonthDayYear
Date
Time
Grade
Referring Staff
Location

BathroomHallwayBusLibraryCafeteriaOff-CampusClassroomOfficeCommon AreaPlaygroundComputer LabSpecial EventOther
Staff Managed Behavior

Defiance/Non-complianceDisrespectDisruptionDress CodeInappropriate LanguagePhysical ContactProperty MisuseTardyTechnology ViolationOther
Administrator Managed Behavior

Abusive/ Inapp. LanguageBullyingDefianceDisrespectDisruptionDress Code
Alchohol

FightingForgery/Theft/PlagiarismGang Display/AffiliationHarassmentLying/CheatingProperty DamageUse/Posession of:
Alchohol

AlchoholCombustablesTabaccoWeaponsDrugs
Other
*Remember to use our shared definitions
Actions Taken

Conference with StudentIndividualized InstructionLoss of PrivilegeParent ContactRestitutionTime OutIn-School Suspension
Actions Taken

Out-of-School Suspension
In-School Suspension
Out-of-School Suspension
After School Detention (30 Minutes)
Other

Action PendingLunch Detention (20 Minutes)hours/daysOther
Notified

ParentsHomeroom TeacherStudentAdministrationNoneTeacher
Brittan School Behavior Form
Notified

SubstituteUnknown
Staff
Other

PeersStaffOther
Lunch Detention to Be Served (same day if detention received before lunch, next day if detention was received after lunch

After School Detention to be served from 2:50 – 3:20 the following day.
Parent Signature
Date

MonthDayYear
Date
Other Comments
Should be Empty: