Behavior Report in Visual Art

Student____________________________   Time of infraction: ___________       Date______________

Behavior observed:

____ swearing or profane remarks ____ making threatening remarks ____ lying to teacher ____ fighting or bullying ____ excessive talking and/or excessive disruptions ____ disrespect towards teacher (or talking back) ____ disrespect towards classmates ____ theft and/or possession of _______________

___vandalism (to school or personal property) ___throwing things ___refusal to be on task/refusal to cooperate ___pushing/shoving ___leaving classroom without permission ___wandering around the classroom –off task ___misuse of school or personal property ___tardy to class ______________

More details:__________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Consequences:  ____ Minor misconduct    _____Office Referral       ______ ISS Room -Dismiss at: _____

I appreciate your support.  Please call Middle School (phone ) for more information. Discuss this with your child.

Teacher_________________________ date:_____   ______________________________ date:____
                                                                                     (Parent or school personnel signature)  

Note: 2 forms fit on 8 ½ x 11 paper. You could print several and make a pad. Below is a form for elementary related arts.

Behavior Report for Related Arts

Student_________________________________  date__________

Art                Computer              Library               Music              P.E.

Behavior observed:

____ excessive talking and/or disruptions ____ disrespect towards teacher (or talking back) ____ disrespect towards classmates ____  misuse of school or personal property ____  wandering around the classroom –off task ____  pushing/shoving ____  refusal to be on task/ to cooperate

____ vandalism (to school or personal property) ____ throwing things ____ theft ____ leaving classroom without permission ____ inappropriate language ____ lying to teacher ____ fighting or bullying

More details:__________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

I appreciate your support in discussing this inappropriate behavior with your student. Please sign and return this form.

Teacher_________________________________________________________________

Parent______________________________________________________________ date___________