AP1 / AP3 INCIDENT INFORMATION To the Parents of: ID Number: Grade: Date: //
Address: City: State: Zip:
DOB// Race: Sex: SP ED Exceptionality / 504:
Date parent was contacted by Principal/Designee: // Telephone:
Incident Referred by: Incident Time: Incident Location:
This is the referral for the following reasons:
Parents must accompany students to the Discipline Center on the first day of assignment. Your child should attend the Discipline Center for all the days indicated above. The Discipline Center opens at 7:00 a.m. Students must arrive no later than 7:30 a.m. each morning and must be picked up promptly at 1:30 p.m. each afternoon. Transportation must be provided by the parent. Students must behave appropriately while at the Discipline Center and complete assignments as directed by their teacher and/or their moderator. If the student does not attend the Discipline Center the days will be counted as unexcused absences. Continued referrals to the Discipline Center could result in assignment to an alternative program.
AP1–SUSPENSION (Discipline Center Admission Form) Your child has been assigned to the Discipline Center at
BEGINNING DATE: // RETURN DATE: // NO DAYS:
Reason Code: or or If Reason Code #13was selected then choose WEAPON TYPE:
School Administrator: Referring School: Referring School Site Code:
AP3 – RECOMMENDATION FOR EXPULSION Please complete AP3 section below and email (firstname.lastname@example.org) Date Parent was contacted by Principal/Designee //. Method of contact:
Date of Hearing: // Time of Hearing: Your child’s hearing will be held at by the Supervisor of Child Welfare and Attendance assigned to that school unless extenuating circumstances exist.
We regret that is has been necessary to take disciplinary action. If you desire further information concerning this matter, you may contact the school at the following telephone number: -. We are hopeful that our coordinated efforts will lead to better communication and a solution to the problem. Parents have the right to view all of the evidence presented by the school at the expulsion hearing.