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School Suspension Notification Form

This document is a notice of suspension from Robbinsdale Cooper High School. It notifies the parent or guardian that their child, a 16 year old 11th grade student, has received a 2 day out-of-school suspension from October 19-24, 2016 for violating the school's physical contact toward adult policy. According to the notice, the student grabbed their teacher's wrist and refused to leave the classroom after being asked to put their phone away. The parent was notified of the suspension by mail within 48 hours as required.

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152 views1 page

School Suspension Notification Form

This document is a notice of suspension from Robbinsdale Cooper High School. It notifies the parent or guardian that their child, a 16 year old 11th grade student, has received a 2 day out-of-school suspension from October 19-24, 2016 for violating the school's physical contact toward adult policy. According to the notice, the student grabbed their teacher's wrist and refused to leave the classroom after being asked to put their phone away. The parent was notified of the suspension by mail within 48 hours as required.

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api-348938826
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Independent School District 281, Robbinsdale Area Schools

NOTICE OF SUSPENSION

School Robbinsdale Cooper High School Grade 11 Homeroom

To Telephone H

Parent or guardian W
Minneapolis, MN 55411-2934 MARSS#_

Address City Zip Student #

We hereby notify you that 16


Students first name, middle initial, last name Age Birth date

Has been suspended.


___
Out-of-school suspension for 2 day(s) Date(s) 10/19/16-10/24/16
___In-school suspension for day(s) Date(s) Period(s)
Other
___

If the suspension exceeds five school days or is an extension of an initial suspension: (1) State reason the student was suspended for
More then five days or reason suspension is being extended:
(2) Indicate alternative educational program that will be provided to the student after the fifth day:

While suspended, the student may not go to any District 281 school location unless given administrative permission.

Incident Date: 10/19/2016 District policy violated: Physical Contact Toward Adult

Brief statement of facts: teacher attempted to pick up his phone from his desk after

refused to put it away. He then grabbed the teacher's wrist and refused to leave her classroom after the class period had ending.
Statement of Suspended Student (Check one)
___ The student was sent home without an administrative conference because the students conduct created an immediate and substantial
danger to himself or herself or others or property around him or her.

___ The student agrees with the above statement of facts.
___ The student does NOT agree with the above statement of his or her statement is as follows:

The student has a disabling condition under either IDEA or Section 504 of the Rehabilitation act:
IEP Yes
___ Special Ed Assessment in Process ___ Yes 504 ___ Yes

No No No
___ ___ ___
If yes to IEP, Assessment or 504 attach Parent Rights and Procedural Safeguards to parent copy.
If the suspension imposed is for 5 or more consecutive days (or exceeds 10 cumulative days within the school year), your childs case manager
will contact you to arrange a team meeting. If you would like to request a meeting to discuss the suspension, please contact
at .

RE-ADMISSION PLAN: Parent meeting was held on 10/18/16. Work completion at BOOST.
RECORD OF NOTIFICATION
Indicate the method(s) by which the parent or guardian was notified of the suspension.

___ Phone call/message.


___ Personally served upon the student at the time the suspension was imposed, and served upon the parent by mail within 48 hours.
___
Served upon both student and parent by mail within 48 hours.
___ Served upon both student and parent by certified mail with return receipt request within 48 hours.

(Name of person making delivery.)

Signature of administrator Print three copies: Parent/Student/School


Attached is a copy of the Minnesota Pupil Fair Dismissal Act.
Revised Aug. 2004

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