Behavior Reflection Form ~ Burnt Hills-Ballston Lake HS
Take a breath. Calm Down. Reflect.
Name *
What is the name of the teacher who sent you to the office? *
Type in the teacher's name.
Give us an overview of what happened and who was present. *
Just describe what happened from start to finish.
Where did this happen? *
Check the appropriate box.
Required
What did you do to contribute to the problem? *
Please think about what your part was in the situation and describe it. This is not about placing blame. It is about considering how your actions contributed.
What could you have done that might have made events unfold differently? *
What other details would you like your assistant principal to know? *
Letter to Parent(s)/Guardian(s) and Teacher/Staff *
Directions: Use the lines below to write a paragraph to both your parent(s)/guardian(s), and the teacher/staff member. The letter you write to inform them about what happened and how the behavior that landed you in the Assistant Principal's office will not occur again. The letter to the teacher should explain your actions and how you will not display that inappropriate behavior anymore. If you feel a letter of apology is appropriate, please check: http://bit.ly/1jTrxx8
Grade *
Submit
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