NOTICE OF VIOLATION OF PROCEDURES
Students name:
*
First Name
Last Name
date:
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Violation Level
*
1st WARNING (ORAL) - WRITTEN DOCUMENTATION TO BE PLACED IN FILE
2ND VIOLATION - ESTABLISHED PLAN TO RESOLVE/COPY IN FILE
3RD VIOLATION - COPY IN FILE/STUDENT SENT HOME FOR THE DAY
4TH VIOLATION - STUDENT DROPPED FROM PROGRAM/NM STUDENT WILL BE PUT ON NM CONTRACT/3 STEP PROCESS
Violation Type
*
DRESS CODE VIOLATION
CELL PHONE
BEHAVIORAL/CONDUCT
4th Tardy NM
COMMENTS:
Instructor Name
First Name
Last Name
INSTRUCTORS SIGNATURE
*
DATE (INSTRUCTOR)
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
STUDENTS SIGNATURE
*
DATE (STUDENT)
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Back
Next
Parent notified
First Name
Last Name
Parent Notified
Phone
Email
Counselor Notified
Phone
Email
*IF STUDENT IS UNDER 18 YEARS OF AGE PARENT AND COUNSELOR NEEDS TO BE CALLED AND/OR EMAILED*
COPY TO BE ENTERED INTO QMULATIVE FOR A NM STUDENT
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