Richland One Hearing Office Referral Form

Male
Female
Yes
No
Yes
No
3.02-Alcohol
3.03-Arson
3.04-Assault/Battery
3.05- Aggravated Assault/Battery
3.06-Theft
3.07-Illegal School Entry
3.08-Vandalism
3.09-Firearms
3.11-Bomb Threat
3.12-Explosives/Ammunition
3.13-Sexual Assault
3.14-Sexting
3.15 Gang Affiliation
3.16-Trespassing
3.17-Major disruption of the Educational Environment
3.18-Unjustified Activation of a Fire Alarm or Fire Extinguisher System
3.19-The UNAPPROVED use of Electronic Devises during School Hours
3.20-Improper Use of Sabotage of a Computer or Computer System or any other Communications System
3.21-Repeated Defiant or Disruptive Behavior
3.22-Threats to a District Employee (Administrator Check this Box
323-Aggravating Bullying, Threat, Harassment or Intimidation
3.24-Gambling

* Required