This form was designed to teach students responsibility and accountability. When a student breaks a rule after a warning, I give them these forms to fill out. Depending on how severe the misconduct was, sometimes students have to get it signed by their parents. You can introduce this as part of a larger classroom management plan. For example, if you use a traffic light system in your classroom this can be the yellow light consequence. Most importantly be sure to introduce this as a serious consequence so students should be afraid to break a rule.