EDUC 300 Discipline Plan Form

DISCIPLINE PLAN

Teacher _Ms. Wingert_________________

Content Area _Music__________

This Discipline Plan is directly related to the rules and procedures

established for this classroom.

Intervention Plan/Consequences
(Steps/Consequences used to respond to student violation of established
classroom rules and procedures)

1. Warning (non-verbal and verbal): Student is given a warning, first non-verbal

and then verbal warning. During the non-verbal warning, the teacher does not
stop instruction and the student will be redirected to get back on task. During
the verbal warning, the teacher will be in proximity to the student and the
student will be redirected to get back on task.

2. Reflection Time: The behavior is addressed and the student is moved to a

specific area in the classroom where he or she is to reflect on their actions and
why this action continues to happen.

3. Conference: Teacher and student conference one on one with each other
discussing the problem, what is causing these actions, and how they can fix it.
This is the time when the teacher can try and understand the student and work
with them one on one to find a resolution.

4. Parent Contact: A letter, email, or phone call is made to contact the parents of
the student to let them know what has been going on in the classroom with their
child and how it has continued to happen and/ or escalate. The teacher and
parents try to discuss a plan of action to help resolve the issues.

5. Office: Child is sent to the office for the principal or higher to discuss with the
child the issues and behavior that has not been resolved in the classroom.

Logical Rewards (optional)

1. ____________________________________________________________
2. ____________________________________________________________
3. ____________________________________________________________
4. ____________________________________________________________
5. ____________________________________________________________
Students: I have read this classroom discipline plan and understand it. I will honor it while in this
classroom.

Signature _______________________ Date _________________________

Parents: My child has discussed the classroom discipline plan with me. I understand it and will support it.

Signature _______________________ Date _________________________

Teacher: I will be fair and consistent in administering the discipline plan for this classroom.

Signature _______________________ Date __________________________

Please keep this sheet in your binder. Thank you.