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Discipline Form
8/4/2016

Whitwell High School Discipline Report

Student's Name: _________________________________        Grade: _________       Date: ___________________

Referring Staff Member: _________________________         PLEASE GIVE DETAILS ON BACK OF FORM


Category I

 

C101

Refusing to do assigned work

 

C109

Unauthorized presence on another school campus

 

C102

Tardiness (class or school)

 

C110

Loitering (no student remains after last bus leaves)

 

C103

Refuses to participate in required school activities

 

C111

Inappropriate public display of affection

 

C104

Minor violation of school or class rules

 

C112

Open food or drink without permission

 

C105

Disorderly conduct/school or learning environment

 

C113

Unauthorized use of copy machine, computer, phone

 

C106

Bus misbehavior

 

C114

Possession of a cell phone

 

C107

Misbehavior for a substitute

 

C115

Invalid immunization records

 

C108

Dress code violation

 

 

 

Punishment

_____ Warning Note Home - Note # _______

_____ Parent contacted by phone

_____ ISS ________ days

_____ Before / After school detention - 85 minutes

_____ Referred to Alternative School ________ days

_____ Corporal Punishment

_____ Administrator met with student

_____ Cell phone at WHS office

_____ Student denied privileges

 

Category II


 

C201

Fighting

 

C214

Misuse/destruction of school property

 

C202

Foul or abusive language

 

C215

Extortion

 

C203

Disrespect to teacher/staff/peer

 

C216

Sexual misconduct (see Board Policy)

 

C204

Harassment (verbal or physical)

 

C217

Participation in school disruption

 

C205

Assault (verbal or physical)

 

C218

Possession/sale/distribution of stolen property

 

C206

Use/possession of tobacco

 

C219

Trespassing on school property

 

C207

Use/possession of incendiary device

 

C220

Prescription drug policy violation

 

C208

Insubordination (not following school employee directive)

 

C221

Unauthorized possession or use of school keys

 

C209

Left school grounds/class without permission

 

C222

Gambling

 

C210

Repeated refusal to do work

 

C223

Computer hacking or tampering

 

C211

Chronic disruption

 

C224

Stealing (may be reported to police)

 

C212

Failure to provide correct identity/address

 

C225

Bullying/threats/hazing or intimidating behavior

 

C213

Dishonest/copying/cheating/forging signatures, etc.

 

C226

Defiance

DISCIPLINE  BY PRINCIPAL / ASSISTANT PRINCIPAL ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

 

 

 

 

Parent's Signature: ____________________________________________________________________________________