Author: Michelle Mcmahon

Hawthorne PBIS
Discipline Referral

	Minor / Handled by Teacher/Staff	Major / Sent to Administrator
Bullying/Harassment / Disrespectful messages (verbal or gestures) that includes threats and intimidation, obscene gestures, pictures, or written notes	Name calling / Gossip / Peer pressure (creating drama) / Spreading rumors / Teasing	Harassment / Verbal threatening / Cyber bullying / Racial, cultural, sexual etc., harassment
Disrespect / Failure to respond to adult requests refuses to follow directions and/or delivers socially rude interaction.	Rude or non-compliant body language / Talking back / Ignoring direction / Questioning authority / Refusing to do class work / Speaking rudely during class	Challenging authority / Minor behavior escalates
Disruption / Causing a disruption or interruption in a class or activity	Talking during instruction / Blurting out / Rolling/tapping pencil or other object / Making random noises / Playing/bringing toys or equivalent / Wasting class time/clowning around / Passing notes / Side conversations during instruction	Yelling, screaming / Kicking chairs/pulling a chair out from a student / Throwing objects with malicious intent / Minor behavior escalates
Forgery/Theft Possession of, having passed on, or being responsible for removing some else’s proportion or has signed a person’s name without that person’s permission	Signing parent’s name on homework / Using classmates school supplies without permission / Signing name on another student’s work	Stealing personal/school property / Signing parent name on important documents (permission slips, discipline notes, school/district forms, etc.)
Inappropriate Language / Inappropriate language/refuses to follow direction	Profanity / Name calling / Talking back	Challenging authority / Obscenities / Inappropriate gestures (foul, hateful) / Minor behavior escalates
Inappropriate Location/Out of Bounds / Being in an area that is outside of school boundaries	Outside of the red line and/or other boundary areas / Hiding from staff / Playing behind the portable classrooms / Knocking on classroom doors to “help” in other classrooms without permission	Leaving the classroom without permission / Leaving school without permission
Lying/Cheating / Student delivers message that is untrue and/or deliberately violates rules.	Cheating on a class test / Lying about homework / Denial of behavior / Cheating at a game	Cheating on a state/district test / Lying when it causes injury / False accusation / Lying about stealing or to cover up
Physical Contact / Aggression/Fighting / Engages in actions involving serious physical contact where injury may occur	Pushing, pulling, scratching / Play fighting / Throwing objects at someone with intent / Annoying contact / Careless or unintentional contact	Spitting, biting or punching / Knocking someone to ground/wall / Aggressive contact / Causing intentional harm
Technology Violation Engages in inappropriate use of technology	Cell phone use during school hours / Changing computer settings / Off-task search / Careless use of technology	Inappropriate website search/use / Changing someone else’s work / Damaging technology / Cyber-bullying / Unauthorized campus videos or pictures