Desert Horizon

REPORT TO HOMEROOM TEACHER

(not step 4/5)

________________________________________      ________________________ 
Student                                                                          Homeroom Teacher
______________     _________________      _______________________________
Date                           Time                                Location

I observed the student doing the following:

  • Not in assigned area
  • Playing in Irrigation
  • Improper use of Equipment/Property
  • Not Waiting for Crossing Guard
  • Arguing with Students
  • Riding Bike/Skateboard on Sidewalks/Campus
  • Inappropriate Language
  • Unsafe Walking To/From School
  • Bullying, Rough Play
  • Teasing
  • Not following Game Rules
  • Other/Out of Classroom Incident
  • Not Following Cafeteria Rules

    (Explain Cafeteria Rule): _________(Explain):
    __________________________________________________________________
    __________________________________________________________________
    __________________________________________________________________

    ____ Student was on Steps (1.2.3? Explain):
    __________________________________________________________________
    __________________________________________________________________

    __________________________
    Staff Member Signature

    Give the original to Homeroom Teacher IMMEDIATELY so the report can be brought up in Points. Homeroom teacher saves the original in the student's classroom file.

    Note:  The original is on 2-part NCR paper to help with record keeping.

     
    Thanks to Desert Horizon School

    Pendergast School District

    Arizona