In House Infractions

Enter a number for each response. If you did not issue a referral for an infraction then enter zero.(0)
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A red asterisk (*) indicates required questions.

  1. How many referrals did you write for insubordination;
    Excessive talking.*


  1. How many referrals did you write for insubordination;
    Failure to follow directions.*


  1. How many referrals did you write forinsubordination;
    leaving without permission.*


  1. How many referrals did you write for insubordination;
    Eating in class.*


  1. How many referrals did you write forinsubordination;
    Failure to do classwork.*


  1. How many referrals did you write for insubordination;
    no pencil or materials.*


  1. How many referrals did you write for insubordination;
    Other: _____please list reason.*


  1. How many referrals did you write for truancy;
    tardy for class.*


  1. How many referrals did you write for truancy;
    cutting class.*


  1. How many referrals did you write for truancy;
    skipping school.*


  1. How many referrals did you write for truancy;
    No admit. *


  1. How many referrals did you write for aggression:
    fighting. *


  1. How many referrals did you write for aggression:
    destruction of property.*


  1. How many referrals did you write for aggression:
    threats/intimidation.*


  1. How many referrals did you write for aggression:
    bullying.*


  1. How many referrals did you write for aggression:
    harassment.*


  1. How many referrals did you write for aggression:
    arguments.*


  1. How many referrals did you write for aggression:
    rudeness/disrespect.*


  1. How many referrals did you write for aggression;
    gang activities.*


  1. How many referrals did you write for inappropriate remarks;
    profane language toward others.*


  1. How many referrals did you write for inappropriate remarks;
    using profanity.*


  1. How many referrals did you write for inappropriate remarks;
    obscene gestures.*


  1. How many referrals did you write for uniform;
    improper shirt.*


  1. How many referrals did you write for uniform;
    improper shoes.*


  1. How many referrals did you write for uniform;
    improper jacket.*


  1. How many referrals did you write for substance abuse;
    drug/alcohol use.*


  1. How many referrals did you write for substance abuse;
    drug possession.*


  1. How many referrals did you write for substance abuse;
    smoking.*





Ms. Hall
Technology Specialist
Gary Community Service Center
Gary, IN