Request For Restorative Practices
Please fill out this form to request a Restorative Practice.
Position of person requesting
Type of Restorative Practice being requested
Reflection with student
Peer Mediation (facilitated by students)
Restorative Conference/Mediation (facilitated by Ms. Molly)
Community building circle (classroom, team, group, etc.)
Peace circle (larger group conflict)
For conflicts, when did the problem begin?
Names of people involved in conflict
Is this process being used in lieu of, or to reduce the duration of, a suspension?
Brief description of conflict/issue
For student reflections: can the student return to class after the reflection/conversation?
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