Use this form to document student behavior, allow student to reflect on behavior and communicate student behavior with parents/guardians.
If a student is making poor choices/negatively affecting the learning of other students, I send them to the behavior reflection station (which is a desk at the back of the room). They remove one of these sheets from the folder, and work on it at the desk, or in another teachers classroom. When they are finished, and I've approved it, we have a conference and then they return to class.
I've included one sheet that includes student & teacher signature lines for classroom use, and another that includes a third line if you'd like to send it home for a parent signature.
Typically, when I send this home with a student for the first time, I include a note to the parent explaining the purpose of the sheet and the actions that were taken prior (the student received verbal warnings and had a conference with the teacher).