View Discipline Review Committee (DRC) Form
School :
Grade :
Date of Violation :
Student First Name :
DOB :
age :
Race :
Student Last Name :
Student State ID :
Gender :
Does Student have Ril plan ? :
Does Student have 504 plan ? :
Does Student receive counselling services ? :
If Student is in regular education, does student have a pending special education test session ? :
Parent/Guardian
First Name :
Last Name :
Home # :
Address :
Work # :
City, State, ZIP :
Call # :
Code # and Description of Violation(s)
Were there Witnessess to the Accident?
Were there BOE Employees as Witnesses?
# of persons involved :
Employees :
Parents :
Other :
Check If Applicable
Weapon
Firearms
Drugs/Alcohol