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TICAL- TriCUE - Dean's Office
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* Indicates required question
Student Last Name
*
Your answer
Student First Name
*
Your answer
Birthday or Student ID
Ex: 08/05/2009
Your answer
Grade
*
Choose
5
6
7
8
9
10
11
12
Period
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Choose
1
2
3
4
5
6
Small Learning Community / School / Organizational Unit
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SLC 1
SLC 2
SLC 3
SLC 4
Teacher Name
Teacher last name only, Don't use Mr. or Mrs.
Choose
Teacher 1
Teacher 2
Teacher 3
Behavior
*
Severe Classroom Disruption
Profanity
Vandalism/ Graffitti
Fighting
Possesion of Controlled Substance
Possession of Weapons
Sexual Harassmnet /in appropriate touching
Chronic Referrals
Threats to Staff
Assault / Battery
Gang Related Activities
Hate Crime
Stealing
Classroom Suspension
Defiance / Insubordination
Other:
Required
Comments
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Teacher Interventions
*
Loss of Points or Privileges
Restitution-Apology
Changed Student Seat
Written Work Assigned
Detention Assigned by Teacher
Talked Privately with student
Parent Contacted
Other:
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Password
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