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    Restorative Justice Form

    Uploaded by

    Ray Lockwood
    This document is a form for students to fill out when they have broken a classroom norm. It asks the student to identify the norm broken, explain why they broke it, provide their perspective, and choose interventions to get back on track such as moving seats or having a parent conference.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Restorative Justice Form

    Uploaded by

    Ray Lockwood
    30 views1 page
    This document is a form for students to fill out when they have broken a classroom norm. It asks the student to identify the norm broken, explain why they broke it, provide their perspective, and choose interventions to get back on track such as moving seats or having a parent conference.

    Original Description:

    rf

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    This document is a form for students to fill out when they have broken a classroom norm. It asks the student to identify the norm broken, explain why they broke it, provide their perspective, and choose interventions to get back on track such as moving seats or having a parent conference.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    30 views1 page

    Restorative Justice Form

    Uploaded by

    Ray Lockwood
    This document is a form for students to fill out when they have broken a classroom norm. It asks the student to identify the norm broken, explain why they broke it, provide their perspective, and choose interventions to get back on track such as moving seats or having a parent conference.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    RJ Form

    Student Name _____________________________________ Section _________ Date _________

    What community norm did I break?


    ❏ One mic ❏ Put in my best effort

    ❏ Respect others ❏ Respect the class environment

    ❏ Student Contract ❏ Follow teacher directions


    (uniform, electronics, food)

    Why? (you may check more than one)


    ❏ I was bored. ❏ I was disrespected.

    ❏ I wanted to have fun. ❏ I wasn’t treated fairly.

    ❏ I didn’t understand the work. ❏ Other


    ______________________________

    Explain your perspective:

    ____________________________________________________________________________________

    ____________________________________________________________________________________

    ____________________________________________________________________________________

    Please check 2 interventions that you are willing to try to get back on track?
    ❏ Not needed, I’m ready to work ❏ Attend office hours.

    ❏ Have a mediation. ❏ Move to an independent seat

    ❏ Have a parent/teacher conference. ❏ Other


    ______________________________

    Parent Name (Print)__________________________________________________

    Parent Signature ____________________________________

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