Form Osr-3 - Notice Of Suspension
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1THE SCHOOL DISTRICT OF PHILADELPHIA
(Insert school name & contact information below)
Philadelphia, PA 191
Phone:
Fax:
NOTICE OF SUSPENSION
Student Name:
Student ID:
Date:
Number of Days:
Any student found in the building while on suspension is subject to
arrest and prosecution for trespassing.
This suspension resulted from the following violations of the School District of
Philadelphia’s Code of Student Conduct:
(Suspension Code)
Rule #
Disruptive Behavior(s)
Description of Misconduct:
NOTICE TO PARENT/GUARDIAN: A conference has been scheduled for
the purpose of reinstatement and/or recommendation of the student for
further disciplinary action.
Date:
Time:
The student must return to school with the parent/guardian listed on the School
Computer Network. If this is not convenient, the parent should call the school at
to reschedule the conference.
(SIGNATURE OF PRINCIPAL OR DESIGNEE, POSITION TITLE)
,
(SIGNATURE OF DISCIPLINE/SCHOOL CLIMATE DESIGNEE, POSITION TITLE)
,
Student has been reinstated on
by
.
(DATE)
(PRINCIPAL OR DESIGNEE)
STUDENT IS PERMITTED TO RETURN TO SCHOOL UPON COMPLETION OF SUSPENSION.
OSR-3 (Rev. 8/2014)
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Parent category: Education