Student Name:* First Last Student Number (Optional - But Helpful) Grade:* 7th (2025) 8th (2024) Date and Time of Incident* MM slash DD slash YYYY : Hours Minutes AM PM AM/PM Given By:*Armantrout, CurtisBarker, AlexBigelow, KahanaBodell, JenBolman, BrittanyBorha, LawrenceBrich, NancyBrown, NoraBrundage, BreeCarroll, MariChristensen, DawnCole, MeganCoons, JillCuomo, ChristineEaton, DianeEdwards, CraigElander, SamFerrarons, AlbertGonzales, NickGuardado, AprilHandy, HeatherHay, KelliHortin, MelindaHowe, TylerHuber, ErinKiisel, JanKosakowski, LenaeIpson, RebeccaLineback, TimLobendahn, KristineLongstaff, AlyssaMark, CielMark, DebMoore, TylerMorales, TerecitaMorgan, PauletteNielsen, MarlaOlsen, AmiePederson, AmberReecer, EveReymus, MoniqueReynolds, LinzieRivera, AlejandroRobinson, GabyRolan, JanRolan, JeffSanchez, NicoleSchaffer, JerryShay, PattySlater, AlishaSmith, DebStansbury, NicoleTodd, RyanVanier, PhillippeWall, SarahWatts, BeckyWatts, CraigRule Infraction:* "Respectful" (Showing Respect) "Accountable" (Shouldering Individual Responsibility) "Zero-quitting" (Being on Task) Location:* Auditorium Bathroom Cafeteria Classroom Hallway Gym Large-group Meeting Room Library Outside STEM Labs Action Taken/Requested Action:* Documentation Only Restitution Loss of Privileges Assigned Clean Up Brief Conference with Teacher Phone Call Home by Teacher Sit-Down Conference with Teacher During Teacher Prep Period (Ask Counseling Office to Call Student Down During Your Prep Period) Conference with Administrator Conference with Administrator & Teacher (During Teacher Prep Period) Immediate Office Referral (For Fighting, Drugs/Alcohol, Vandalism, Weapons, Gang Activity, Harassment, or Severe Defiance to Adults) Lunch Detention (Assigned by an Administrator) In-School Suspension (Assigned by an Administrator) Out-of-School Suspension (Assigned by an Administrator) Description or Comments:This will be communicated to the parents. Please make sure it is objective. A helpful hint is to describe what led up to the behavior, what was the behavior, and what happened as a result of the behavior (A - Antecedent, B - Behavior, C - Consequence).