School Behavior Incident Report

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I. Incident Details

Date	May 15, 2050
Time	10:30 AM
Location	[YOUR COMPANY NAME] [YOUR COMPANY ADDRESS]
Reported By	[YOUR NAME]
Student(s) Involved	[STUDENT'S NAME]
Grade/Class	10th Grade, English Class

II. Incident Description

On May 15, 2050, during third-period English class, a behavioral incident occurred involving [STUDENT'S NAME]. The student was observed engaging in disruptive behavior, including loudly talking over the teacher during instruction and refusing to comply with repeated requests to cease the disruptive behavior. The student was disrupting the learning environment for his peers and preventing the teacher from effectively conducting the lesson.

III. Witnesses

• William Hart, Faculty Member

• Laura Bubb, Classmate

IV. Actions Taken

• Verbal Warning: [YOUR NAME] verbally warned [STUDENT'S NAME] to stop the disruptive behavior and reminded him of the classroom rules.

• Second Warning: Despite the initial warning, the student continued his disruptive behavior. The teacher issued a second verbal warning, emphasizing the seriousness of the situation and the consequences of further disruptions.

• Referral to Principal: As the student's disruptive behavior persisted despite warnings, the teacher referred him to the school principal, Mrs. Annalisa Thomas, for further disciplinary action.

• Parent Notification: The principal informed the student's parent/guardian about the incident and requested a meeting to discuss the behavior and its consequences.

V. Follow-Up Actions

• Parent Meeting: A meeting will be scheduled with the student's parent/guardian to discuss [STUDENT'S NAME]'s behavior, its impact on the classroom environment, and the next steps for addressing the issue.

• Behavior Contract: A behavior contract will be developed in collaboration with the student, his/her parent/guardian, [YOUR NAME], and Mrs. Thomas. The contract will outline specific expectations, consequences for future disruptions, and strategies for improving the student's behavior.

• Counseling Referral: Mrs. Thomas will refer the student to the school counselor, Ms. Blanchard, for additional support and guidance in addressing any underlying issues contributing to his disruptive behavior.

VI. Additional Comments

The school takes incidents of disruptive behavior seriously and is committed to providing a safe and productive learning environment for all students. [YOUR NAME] will continue to monitor [STUDENT'S NAME]'s behavior closely and provide support as needed to help him succeed academically and behaviorally.

VII. Incident Resolution

• Principal's Decision: Following a meeting with the student's parent/guardian and [STUDENT'S NAME], Mrs. Thomas determined that the student would be assigned 3 days of in-school suspension as a consequence for his disruptive behavior.

• Parent Confirmation: The student's parent/guardian has been notified of the disciplinary action, and she has confirmed receipt of the information and agreed to support the student in adhering to the behavior contract.

VIII. Future Monitoring

• Teacher Monitoring: [YOUR NAME] will closely monitor [STUDENT'S NAME]'s behavior during English class and provide regular feedback on his progress toward meeting the expectations outlined in the behavior contract.

• Counselor Follow-Up: Ms. Blanchard will schedule regular follow-up sessions with the student to assess his behavior, provide additional counseling support, and help him develop strategies for managing his behavior effectively.

IX. Conclusion

The incident involving [STUDENT'S NAME] has been addressed through appropriate disciplinary measures and support mechanisms. The school administration, teachers, and counselors are committed to ensuring the student's success by providing the necessary guidance and support to address his behavioral challenges. We hope that through collaboration with his family and the implementation of the behavior contract, the student will demonstrate positive changes in his behavior and contribute positively to the school community.

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