Name: ____________________________ Date: _________________
You are being cited for inappropriate classroom behavior based on the Social Contract you agreed to our first
day of school. As an intelligent fourth grader with a bright future ahead of you, I expect more from you. It is up
to you to make appropriate choices for yourself. I sincerely hope this is the last Classroom Citation you ever
receive in my classroom. It can be—you have to make the choice.
The behavior occurred:
T in class
T at an assembly
T with a guest teacher
Specific Behavior: __________________________________________________________________________
As a result of you receiving this Classroom Citation, you WILL NOT be eligible to participate in our class’s end-of-month
Awards Gala, which includes a pizza party. You WILL, however, write a two-page paper about your behavior and
how you can choose to avoid it next time. You WILL write the paper neatly and attach it to this citation, along with
a letter of apology to me for your disruption. Therefore, by TOMORROW, you will return the following: this
citation signed by your parent or guardian, the two-page paper about your behavior choice(s), and a letter of apology.
All documents shall be stapled to this citation.
It is my sincere hope that you learn from your mistake(s) and refrain from making them again. The choice is yours.
Mrs. Bentheim, Sixth Grade Reading
Parent/Guardian Signature Student Signature