Document page
Policy on Disruptive Social BehaviourPDF 30
37 pagesrevision 47076
PDF 30
Page image rendered from the stored file at 110 dpi; it sharpens as you zoom. Outlines are placed from each region’s stored position on the page (612 × 792 pt).
readable
Source of this text: embedded text layer. The better of the embedded text and OCR is kept.
Annexe 6: Sample Format for Student Reflection on Own Behaviour
This reflection form will help you think critically about your behaviour, take responsibility for your actions, and
develop a plan to improve your behaviour.
You are required to sit quietly and reflect on what happened. You have 30 minutes to hand your reflection to
your teacher. Your Head Master/Mistress may also read this. It will be documented in your personal file
Name:_____________________
School:____________________
Class: ________________________
Incident Description
Date:_____________________
Time: ____________________
Location: _____________________
Briefly describe the incident
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
My Actions
What did I do during the incident?
__________________________________________________________________________________________
How did my actions affect others?
__________________________________________________________________________________________
What I Learned
What did I learn from this experience?
__________________________________________________________________________________________
_________________________________________________________________________________________
What would I do differently if faced with a similar situation?
__________________________________________________________________________________________
__________________________________________________________________________________________
My Action Plan
What steps will I take to improve my behaviour?
__________________________________________________________________________________________
__________________________________________________________________________________________
Student Signature: _____________________
Date: _________________________
Policy on Disruptive Social Behaviours, Aitchison College
30