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Conduct Poa

This document appears to be a classroom behavior tracking form and reflection assignment for a student. It tracks the student receiving two verbal warnings for disrupting class by speaking out of turn, followed by a private conversation. The student is then asked to write responses to questions about their disruptive behavior, its consequences, and a plan to improve. If the student does not meet to discuss their responses, the teacher will contact their parents or guardians.

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89 views2 pages

Conduct Poa

This document appears to be a classroom behavior tracking form and reflection assignment for a student. It tracks the student receiving two verbal warnings for disrupting class by speaking out of turn, followed by a private conversation. The student is then asked to write responses to questions about their disruptive behavior, its consequences, and a plan to improve. If the student does not meet to discuss their responses, the teacher will contact their parents or guardians.

Uploaded by

api-308978657
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Student Name: _________________________________

Period _____

Date

Verbal Warnings in class (1 & 2)

_______

[ ] Speaking during classroom instruction.


[ ] Other. ______________________________________

_______

[ ] Speaking during classroom instruction.


[ ] Other. ______________________________________
Verbal Warning - Private (3)

_______

[ ] Speaking during classroom instruction.


[ ] Other. ______________________________________

Writing Reflection by student (4)


_______

[ ] Speaking during classroom instruction.


[ ] Other. ______________________________________

Call or meet with parent/guardian (5)


_______

[ ] Speaking during classroom instruction.


[ ] Other. ______________________________________

Send student to office with discipline referral (6)


_______

[ ] Speaking during classroom instruction.


[ ] Other. ______________________________________

Dear Student,
You are being asked to write about your conduct in the classroom. The
reason is because its consequences are disrupting classroom instruction.
Your disruptive conduct continues despite you having received two in class
verbal warnings and one private conversation with your teacher with the
intention of correcting your conduct
Please answer the following questions in complete sentences.
Thinking of my conduct and its consequences.
What am I doing that disrupts class instruction?
Who was involved?
Why did I choose to conduct myself in this manner?
What consequences does this conduct have on my ability to learn and on my
parents or guardians?
What consequences does this conduct have on my classmates ability to learn
and on their parents and guardians?
What are the consequences of this conduct on my teacher?
Plan for Improvement
What will I do to improve my conduct?
--------------------------------I will return my responses and meet with Mr. Villarreal on the following date:
_________ / ________ / _____________
I understand that if I do not meet with my teacher, Mr. Villarreal, he will
contact my parents or guardians.
Student: __________________________

Date: _________

Teacher: __________________________

Date: _________

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