subject_line
Rich Central Discipline Referral
Date
*
Staff Information
First Name
*
Last Name
*
eMail Address
*
Confirm your email address
*
Student Information
Student First Name
*
Student MI
Student Last Name
*
Student ID #
*
Student Grade
*
9
10
11
12
Referral
Date of Infraction
*
+
Hour of Infraction
*
0
1
2
3
4
5
6
7
8
9
10
11
12
Minute of Infraction
*
00
15
30
45
AM/PM
*
AM
PM
Problem Behavior
*
Academic Integrity
Alcohol
Arson
Battery to Another Student
Battery to Staff Member
Bomb Threat
Bookbag in Class
Bus Incident
Cafeteria Incident
Classroom Disruption
Dangerous Item
Dangerous Weapon
Disrespect - Minor
Disrespect - Major
-
Disruption - Minor
Disruption - Major
Dress Code
Driving Violation
Drug Offenses
Electronic Devices
Endanger Health and Safety
Excessive Tardies
Excessive Truancies
False Phone Call
Fighting/Physical
Fire Alarm
Forgery
Gambling
Gangs
Gross Miscunduct
Harassment/Hazing/Bullying
ID Infraction
In Hall Without Pass
Inappropriate Behavior
Instigating
Insubordination
Loitering
Lying/Cheating
Misuse of Handbook/Pass
Mob Action
No Show Detention
No Show to In-School Suspension
Other Behavior
Possession of Stolen Goods
Profanity
Profanity to School Personnel
Sexual Harassment
Social Media Misconduct
Tardy 3
Tardy 4
Tardy 5
Theft
Threat
Tobacco
Trespassing
Truancy Step 1
Truancy Step 2
Truancy Step 3
Truancy Step 4
Truant
Unauthorized Area/Safety Concern
Vandalism
Verbal Assault - School Personnel
Verbal Confrontation
Violation of Acceptable Use Policy
Violation of Bus Suspension
Violation of Contract
Violation of Peer Mediation
Violation of Sign In/Out
Violation of Suspension
Other Behavior
Location
*
Assembly
Auditorium
Bathroom
Bus
Bus Loading Zone
Cafeteria
Classroom
Field Trip
Football Field
Gym
Hall
Locker Room
Media Center
Off-Campus
Office
Other Location
Parking Lot
Practice Field
Special Event
Stadium
Unknown Location
Other Location
Incident Details
*
0/500 characters
Case Disposition - For Deans' Use Only
Disposition
After School Detention
Behavior Contract
CIBS Placement In Lieu of Out-of School Suspension
CICO - Attendance
CICO - Discipline
Conference
Detention
Detention - Saturday
Drop W/F
Hold in School Suspension
In-School Suspension
Loss of Privilege
Lunch Detention
Mandatory Parent Conference
Mediation Process
OSS - Referred to Administrative Council
Out of School Suspension
Period SIS
Referred to Administrator
Referred to Special Education
Referred to Support Staff
Removal to an Interim Alt Ed Setting by a Hearing Officer
Restitution
Restorative Justice
Service Learning
Social Suspension
Summer Work - Bookroom
-
Suspension from Bus
Suspension from Cafeteria
Suspension from Class
Suspension from Media Center
From
+
To
+
Return On
+
Period
None
All
Half Day
1
2
3
4
5
6
7
8
Days
1
2
3
4
5
6
7
8
9
10
Total Days
Other Action Taken
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