Student: SAMPLE STUDENT__ Date: · Web viewStudent: SAMPLE STUDENT ......

Student: ____SAMPLE STUDENT__________ Date: ___11/29/2012_______

*SAMPLE* Expulsion Packet

Student: __SAMPLE STUDENT________ Grade: ___12_______

The following sections are included in this packet:

1. Investigation report2. Certified letter of notification to

parent/guardian3. Report card4. Attendance record5. Progress report6. Discipline/behavior record7. Recommendation

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Section 1

Investigation Report

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Please provide a description of the behavior that lead to an expulsion recommendation.

The following is a report prepared for the expulsion hearing of:

_________SAMPLE STUDENT_________

Date:____11/29/2012________

Person completing report:__BUILDING ADMINISTRATOR____

Investigation Report

BOTTOM LINE: SAMPLE has a serious behavior/discipline record that indicates his inability or unwillingness to control his behavior in and around school. He has assaulted several students as well as a staff member and endangered a worker near the building. He has been suspended numerous times for these offenses. These behaviors are compromising the safety of the staff and students at NAME OF SCHOOL and disrupting the educational process for himself and others.

RECOMMENDATION: Expulsion for the remainder of the 2012/2013 school year.

AUTHORITY: 1. ORS 339.250 (3), (4)

2. OAR 581-21-055 Standards of Conduct

3. Redmond School District School Board Policies Section J

4. NAME OF SCHOOL Handbook

SAMPLE STUDENT is here for violation of ORS 339.250 (3), (4) stating “The district school board may authorize the discipline, suspension or expulsion of any refractory student and may suspend or expel any student who assaults or menaces a school employee or another student. The age of a student and the past pattern of behavior of a student shall be considered prior to a suspension or expulsion of a student. As used in this subsection

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menace means by word or conduct the student intentionally attempts to place a school employee or another student in fear of imminent serious physical injury.

(4)(a) Willful disobedience, willful damage or injury to school property, use of threats, intimidation, harassment or coercion against any fellow student or school employee, open defiance of a teachers authority or use or display of profane or obscene language is sufficient cause for discipline, suspension or expulsion from school.”

SAMPLE STUDENT also violated OAR 581-21-055 Standards of Conduct stating “(1) Students shall comply with the written rules of the school district board, pursue the prescribed course of study, submit to the lawful authority of teachers and school officials, and conduct themselves in an orderly fashion.

(2) Students shall be liable to discipline, suspension, or expulsion for misconduct, including but not limited to:

(a) Theft;

(b) Disruption of the school;

(c) Damage or destruction of school property;

(d) Damage or destruction of private property on school premises or during a school activity;

(e) Assault or threats of harm;

(f) Unauthorized use of weapons or dangerous instruments;

(g) Unlawful use of drugs, narcotics, or alcoholic beverages;

(h) Persistent failure to comply with rules of the lawful directions of teachers or school officials.

SAMPLE STUDENT was in violation of Redmond School District Policy JFC Rules for Student Conduct and Policy JFCM for Threats of Violence. SAMPLE has specifically engaged in the following behaviors:

Disruption: Student engages in behavior causing an interruption in a class or activity. Disruption includes sustained loud talk, yelling, or screaming; noise with materials; horseplay or roughhousing; and/or sustained out-of-seat behavior.

Fighting: Student is involved in mutual participation in an incident involving physical violence.

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Defiance/Insubordination/Non-Compliance: Student engages in refusal to follow directions or talks back.

Physical Aggression: Student engages in action involving serious physical contact where injury may occur (e.g., hitting, punching, hitting with an object, kicking, hair pulling, scratching, etc.).

Harassment: The delivery of disrespectful messages in any format related to gender, ethnicity, sex, race, religion, disability, physical features, or other protected class.

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STUDENT CONDUCT:

Date: Behavior:

9/9/12 Insubordination

9/10/12 Harassment

9/11/12 Inappropriate Language

9/12/12 Harassment


9/20/12 Defiance/Tardy/Inappropriate Language

9/24/12 Fight/Assault

10/3/12 Harassment

10/3/12 Fight/Assault/Inappropriate Language

10/9/12 Defiance

10/14/12 Inappropriate Language/Insubordination/Defiance

10/17/12 Inappropriate Language/Insubordination


10/29/12 Disruptive



11/7/12 Defiance

11/14/12 Harassment

11/25/12 Fight

11/26/12 Assault

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DESCRIPTION OVERVIEW: SAMPLE STUDENT is not a Special Education student. To date, he has been absent 23 days out of 54.

His academic progress report indicates that he is rarely prepared for class, that he participates very little, completes very little work, does not follow directions and often disrupts the class.

His behavior record shows 7 referrals for insubordination, 6 for inappropriate language, 5 for harassment, 3 for defiance, 3 for fighting/assault, and 2 for physical aggression (endangering others).

He has been assigned to in-school-suspension to help him focus in a quiet environment and be productive, he has had his free time privileges revoked and spent free time in the office in an effort to reduce the behavior referrals in the commons and in the hallways. He was removed from his reading group and allowed to read on his own for the period that his class was working in the corrective reading program in an effort to reduce some of the anxiety in his academic day.

SAMPLE sees a school counselor regularly, he is also on THERAPISTS NAME caseload from Mental Health. He was put on a behavior contract that allowed him to remove himself from any situation where he felt anxious and angry before he became overly aggressive and his behavior went out of control.

SAMPLE has been staffed by the Student Support Team. A meeting was held on November 26, 2012 with LIST TEAM MEMBERS PRESENT, to discuss his academic progress, the fact that his behavior has become increasingly dangerous to others and to discuss the possible interventions that could be used during the school day to help SAMPLE gain control over his behavior and accomplish some school work.

SAMPLE left that meeting and at approximately 2:20pm went to the commons, went over to one of the office staff and asked if he could comb her hair. She was talking to another group of student and before she could respond, SAMPLE scraped a broken comb with a single tooth down the side of her head, across her ear, and down her neck. Earlier that same day SAMPLE shook an extension ladder that a worker was standing on repairing the roof outside the building.

SAMPLE has been suspended for 10 days this year to date. All 10 days of suspension were for assault, fighting, or behavior that is dangerous to others. SAMPLE has been given many opportunities to improve his behavior, many interventions have been tried at school

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to assist him in gaining control over his behavior, yet he seems unwilling or unable to comply with the rules and procedures and act safely and responsibly at school.

***Include parent contact log here.

***Include description of any legal records (i.e., citations issued that are related)

For these reasons we are asking that SAMPLE be expelled for the remainder of the 2012-2013 school year.

Re-entry to school is based on the criteria of meeting expulsion expectations and is the decision of the expelling principal and/or the principal at the school the student may be transitioning to.

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Section 2

Certified Letter

Of

Notification to Guardian

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Section 3

Report Card

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Section 4

Attendance Record

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Attendance Record For

Student: SAMPLE STUDENT

Date: 11/29/12

Number of school days to date: 54

Number of days attended: 31

Number of days absent: 23

Percentage of attendance: 57%

Period 1 absences – 37




Student does not have a Period 5.

Breakdown of reasons given for period absences:

Unexcused: 19

Excused: 78

Suspended: 20

In-school suspension: 0

Tardy: 6

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Section 5

Progress Report

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Academic Progress Report

Date range:

Student:

Grade:

PER/STAFF BEHAVIOR/WORK HABITS

PREPARED GRADES

Comments:

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Teacher Input:

Please fill out a progress report on the following student to date. The information will be used to follow up on a discipline concern. Please return to ________________________. Thank you.

Student:_______________________________

Subject:_______________________________ Period:___________

Please rate the following using A-F:

_____ Attendance _____ School work/Participation

_____ Class behavior _____ Prepared for class

Additional comments: ___________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Teacher signature: __________________________________________ Date: _______________

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Section 6

Discipline/Behavior Record

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Behavior Record

For

Student: _____SAMPLE STUDENT______________

Date: ___6/1/2013_______________

Date: Behavior:


9/10/12 Harassment

9/11/12 Inappropriate Language

9/12/12 Harassment


9/20/12 Defiance/Tardy/Inappropriate Language

9/24/12 Fight/Assault

10/3/12 Harassment

10/3/12 Fight/Assault/Inappropriate Language

10/9/12 Defiance

10/14/12 Inappropriate Language/Insubordination/Defiance



10/29/12 Disruptive



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11/7/12 Defiance

11/14/12 Harassment

11/25/12 Fight

11/26/12 Assault

(You are encouraged to print out incident documentation from Synergy and place in this section.)

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Student: SAMPLE STUDENT__ Date: · Web viewStudent: SAMPLE STUDENT ......

Documents

Transcript of Student: SAMPLE STUDENT__ Date: · Web viewStudent: SAMPLE STUDENT ......

Student: ____SAMPLE STUDENT__________ Date: · Web viewStudent: ____SAMPLE STUDENT ......

Documents

Transcript of Student: ____SAMPLE STUDENT__________ Date: · Web viewStudent: ____SAMPLE STUDENT ......

Student: SAMPLE STUDENT__ Date: · Web viewStudent: SAMPLE STUDENT ......

Transcript of Student: SAMPLE STUDENT__ Date: · Web viewStudent: SAMPLE STUDENT ......