GHS Discipline Referral
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Entry Type
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Staff Report
Administrative Response
Teacher Information
Teacher Name
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Teacher Email Address
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Room Number
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Extension
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Student Information
Student Name
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Your answer
Grade
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9
10
11
12
Referral Information
Referral Severity
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Minor Referral
Major Referral
Referral Location
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Classroom
Bathroom
Bus Lot
Cafeteria
Gym
Hallway
Parking Lot
Media Center
Block Offense Occurred
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Before School
1
2
3
4
After School
Reason for Referral
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001 Aiding Others
003 Bite/Pinch/Spit
004 Contraband
005 Detention Violation
006 Dishonesty
007 Disrupting Class
009 Fighting
010 Fireworks
011 Forgery
012 Harrassment
013 Sexual Harrassment
014 Hit/Kick/Push
015 Inappropriate Affection
016 Inappropriate Language
017 Inappropriate Behavior
018 Inappropriate Materials
019 Indecent Exposure
020 Major Disruption
021 No Form Return
022 Inappropriate Physical Contact
023 Property Misuse
024 Running
025 Sex Violation
027 Threat
028 Throwing Objects
029 Urination
150 Cutting School
151 Truant
152 Habitual Truant
153 Chronic Truant
160 Cutting Class
170 Cutting Activity
180 Tardy
190 Cheating
200 Off Limits
210 Profanity
220 Computer Violation
230 Tobacco Violation
240 Loitering
250 Gang Activity
260 Bomb Threat
270 Refusal to Obey
271 Failure to Comply with Disc Action
275 Failure to Complete Work
280 Dress Code Violation
290 Obscene Gesture
300 Parking Violation
305 Driving Violation
310 Leaving School
320 Leaving Class
330 Phone Violation
340 Bus Violation
350 Fire Alarm
360 ID Violation
370 Littering
380 Probation Violation
390 Unauthorized Device
400 Excessive Noise
405 Horseplay
407 Confrontation/Altercation
410 Hall Pass Violation
420 Disrespect
430 Contract Violation
500 Arson
510 Assault, Aggravated
520 Assault, Simple
530 Bribery
540 Burglary
550 Counterfeit/Forgery
560 Disturb School
570 Drug Distribution
580 Drug Possession
590 Embezzlement
600 Extortion
610 Forced Sex Offense
620 Fraud
630 Gambling
640 Homicide
650 Intimidation
651 Bullying
652 Cyberbullying
660 Kidnapping/Abduction
670 Larceny/Theft
680 Alcohol/Liquor Law Violation
690 Non-forced Sex Offense
700 Other Offense
710 Pornography
720 Prostitution
730 Robbery
740 Stolen Property
750 Trespassing
760 Vandalism
770 Vehicle Theft
789 Weapon (Specify Object)
Action Taken Prior to Referral
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Conference with pupil
Call or letter to parents and/or conference with parents
Conference with guidance counselor
Detention/work assignment
Other (please specify in description)
Description
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