LAPORAN KES KESALAHAN DISIPLIN MURID

(Diisi Oleh Guru)

Tarikh:__________________________________________________________________________
Nama Murid:____________________________________________________________________
Tahun:__________________________________________________________________________
No Surat Beranak/ No Kad Pengenalan:______________________________________________
Kesalahan:_______________________________________________________________________
Tempat Kejadian:_________________________________________________________________
Butiran Kes:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Saksi Kejadian:
1.
2.
3.

Perakuan Guru Disiplin:

Saya mengaku bahawa murid di atas telah melakukan kesalahan disiplin. semua keterangan di atas
sesunggunya adalah benar dan dicatat bagi menentukan hukuman atas kesalahan murid.

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Disahkan Oleh: ..
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