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AfterSchoolDetentionReferralForm

Pleasecompletethisformforanystudentwhohas3ormoretardiesordemonstratespoorbehaviorfora
substituteteacher.

*Required

1. ReferringTeacher*

2. Student'sLastName*

3. Student'sFirstName*

4. Student'sGrade*
Markonlyoneoval.

6thGrade
7thGrade
8thGrade
5. Student'sTeam*
Markonlyoneoval.

Stars
Cobalt
Odyssey
Encounter
Crazy8's
Voyager
Unknown

6. ReasonforDetentionReferral*
Markonlyoneoval.

Tardy3TimestomyClass
PoorSubstituteTeacherBehavior

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