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Name of Student

Re-order First Last Weight Operations
Gender
Class Year
Living Situation
Residence Hall
Incident Location
Identifies who/what influenced decision

I made the choice, my friends were drinking, etc.
Acknowledges those impacted by the decision
Hallmates, JCUPD, community, etc.
Identifies the relation between the violation and academic success
I missed class or might have done poorly on a test, etc.
Discusses the correlation between the behavior and the person he/she is working on becoming
I made a bad decision, and it could affect my potential in finding a job, etc.
Autonomous/takes responsibility for the violation
I made a bad decision, and it could affect my potential in finding a job, etc.