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Name What happened? h part of the social contract do you think you failed to follow? —— Be respectful of yourseif, our space and our community ___ Be responsible for your learning and actions. _— Follow directions and school policies. Who was affected? - — What action(s) will you take to make things right? When can this happen? Do you need help from anyone else? Yes__No If yes, what support do you need, and from whom? LTcheck here ifyou have had need to confer with an adul problem before during the last week. You may break the habit or change your behavior. .When you finish raise your hand and wait for the teacher. Student signature, Date, Teacher Notes ‘TAB OUT AND BACK REFLECTION

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