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Click ‘Get Form’ to open the refocus form in the editor.
Begin by entering the Student Name, Teacher's name, and Date in the designated fields at the top of the form.
Indicate the offense by marking either 1ND OFFENSE, 2ND OFFENSE, or 3RD OFFENSE as applicable.
In the provided space, write a complete sentence describing your behavior. You can choose from phrases like 'Talking Out of Turn' or 'Disruptive' to guide your response.
Circle the Key that was violated from options such as Integrity or Commitment.
Next, describe why you chose this behavior using one of the guiding phrases provided.
Outline how you will commit to changing your actions in the future in the designated area.
Finally, indicate whether you are ready to return to class for learning by selecting Yes or No. Ensure both Teacher and Parent signatures are added at the bottom.

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Versions	Form popularity	Fillable & printable
2015	4 Satisfied (27 Votes)

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