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Behavior Log
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* Indicates required question
Student Information
First Name
*
Your answer
Last Name
*
Your answer
Student ID
*
Your answer
Class Period
*
1
2
3
4
5
6
Incident Information
Incident
*
iPad-related (see question below)
Forgot class materials (notebook, pencil, pen)
Disrespectful to other students or adult
Disrespectful to class materials
Talking, calling out, or side conversations
Other:
Required
If iPad related, what is the issue?
Forgot iPad at home
Not using iPad correctly in class
iPad not charged
iPad charger is broken
Other:
What is your consequence?
*
You are responsible for following up with your consequence.
Warning
Chat after class
Phone call home
Detention
Referral
Other:
If necessary, describe what happened:
Your answer
Reflection
How is our classroom impacted by your decisions?
*
Remember, it's usually not just you who is impacted by your choices!
Your answer
What do you need to do now to fix the situation?
*
How can you make this better? Do you need to apologize to someone(s)?
Your answer
Anything else we need to know?
Your answer
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