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Robbinsdale Cooper High School

Restorative Reflection Sheet


Student Name:

Todays Date:

Teachers Name:

Class Period:

How many times was I redirected by the Teacher?


How am I doing Academically in this class?

(circle one)

NC

Why was I sent out of class?:

What are 3 things I could have done to prevent this incident from happening?

Robbinsdale Cooper High School


Restorative Reflection Sheet
Student Name:

Todays Date:

Teachers Name:

Class Period:

How many times was I redirected by the Teacher?


How am I doing Academically in this class?

(circle one)

Why was I sent out of class?:

What are 3 things I could have done to prevent this incident from happening?

NC

Robbinsdale Cooper High School


Who is MY Dean?:
Did my actions or behavior impact the learning of my peers in the classroom? Yes or No
How:

What needs to happen to make things right with all parties involved in this situation?

What additional support do you need to be successful in your classes?

Robbinsdale Cooper High School


Who is MY Dean?:
Did my actions or behavior impact the learning of my peers in the classroom? Yes or No
How:

What needs to happen to make things right with all parties involved in this situation?

What additional support do you need to be successful in your classes?

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