Student Reflection
Please fill out the form. If there are any questions please ask the supervisor.
First name: *
Your answer
Last name: *
Your answer
Grade: *
What happened? (Who was involved, where did this happen, describe the situation in detail, who initiated the issue/conflict.) *
Your answer
How were you feeling at the time of the incident? *
Required
How have you been affected by this? *
Your answer
Have others been affected by this incident? If so, how? *
Your answer
What needs to happen to help resolve this issue? (What needs to happen to help make things right?) *
Your answer
Create a three (3) step plan to avoid this happening in the future. *
Your answer
Here are some ways I could have helped avoid this situation: *
Required
Is there anything else you'd like to share? *
Your answer
How can staff better support you in the future in the future? *
Your answer
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