Tracking Report Form #19

Behavioral Incident Report
2004-2005 School Year

District :    
School :   Last Updated on
Grade In School Suspensions Out of School Suspensions
Male Female Male Female
New Rpt New Rpt New Rpt New Rpt
K
1
2
3
4
5
6
7
8
9
10
11
12
Totals









Grade Truancies Expulsions Fights
  Male Female   Male Female   Male Female
# Inc New Rpt New Rpt # Inc New Rpt New Rpt # Inc New Rpt New Rpt
K
1
2
3
4
5
6
7
8
9
10
11
12
Totals

1. In School Suspensions - The assignment of a student to a restrictive program within the studentís regular school day based upon the studentís misbehavior.
2. Out-of-School Suspensions - Prohibiting school attendance for fewer than ten consecutive days.
3. Truancies - Unauthorized absence from an assigned class or activity during school hours. For reporting purposes, include any truancy where parents are notified in writing or any other administrative action is taken.
4. Expulsions - Prohibiting school attendance, without services and not being placed in an alternative setting, for ten or more consecutive school days.
5. Fights - Pushing, shoving, challenging to fight or fighting.

Directions:
       A. # Incident (Incid) = total number of incidents that occur per grade
       B. Male or Female = number of individuals involved in each incident by gender
       C. New = first offense by student
       D. Repeat (Rpt) = second/additional offenses by same student