Carter High School
Discipline Referral Form(DRF)
Student Details:
Student:
Student #:
Grade:
Please Select
Grade8
Grade9
Grade10
Grade11
Grade12
Staff Details:
Referring Staff:
Date:
Time:
Period:
Please Select
Period1
Period2
Period3
Period4
Period5
Period6
Location Of Incident:
Please Select
Bus
Classroom
Media Center
Corrior
Commons/Common Area
Transport Area
Tuckshop
Office
Toilet
Other
Majors (Office-Managed Behavior)
Abusive/Inappropriate Language:
Cheeting/Integrity:
Repeated late coming:
Defience/Disrespect:
Disruption:
False Alarm:
Fighting/Physical Aggression:
Forgery/Thefft:
Harassment/Bully:
Property misuse or damage:
Truancy:
Use/Possession of Tobacco:
Use/Possession of Alcohol:
Use/Possession of Drugs:
Use/Possession of Combustible Items:
Use/Possession of Weapons:
Vandalism:
Uncooperative:
Missed Detention:
Unprepared/No Materials:
Unauthorised use of electronic device:
Sexual misconduct:
Racism:
Theft/Robbery:
Use/possession of pornography:
Initiation practices:
Xenophobia:
No name badge:
Email/Internet violations:
Use of electronic cigarette:
Other:
Minors (Staff-Managed Behavior)
Inappropriate Language:
Property Misuse:
Physical Contact:
Public Display of Affection:
Late Coming:
Dress Code Violation:
Defience/Disrespect:
Disruption:
Not Prepared for Class:
Other:
Administrative Action
Please Select
Time in Office
Loss of Privileges
Conference with Student
Parent Contact
ASD
Compensation
Referred to Guidance Counsellor
Individualized Instruction
Bus Action/Suspention
In-School Suspension
Out of School Suspension
Assistance Team Referral
Friday Detention
Lunch Detention
Discipline Points
Comments: