Elevo Behavior Report

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For for any behavioral misconduct (and/or repeat occurrences)

Student Full Name *

Date (of misconduct)

YYYY

Comments *

Was the student dismissed? *

Yes

What misbehavior did the student showcase? (Select All)
*

▢ Lack of respect for rights and or property of others / ▢ La falta de respeto de los derechos o propiedad de otros

▢ Refusal to follow leader’s directions / ▢ Se niega a seguir las instrucciones del maestro

▢ Continued violation of school rules / ▢ Continua violacion de las reglas escolares

▢ Disrupting Learning / ▢ Interrupcion de aprendizaje

▢ Discourteous Behavior / ▢ Comportamiento descortes

▢ Fighting, Pushing, or Shoving / ▢ Pelea, empuja, o juega pesado

▢ Use of Profanity / ▢ El uso de malas palabras

Other:

Required

Action taken by coach leading up to report *

▢ Verbal warning / ▢ Advertencia verbal

▢ Change Student’s seat / ▢ Cambio de asiento al estudiante

▢ Conference with student / ▢ Conferencia con el estudiante

▢ Loss of privileges / ▢ Perdida de privilegios

▢ Behavior contract / ▢ Contrato de comportamiento

Other:

Required

Email Address (Elevo Employee)
*

Signature (Elevo Employee):
*

RPM email (For Summer - Choose "Hazel Lewis") *

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