Policy 3545F2 - Student Interview Form

Student Interview Form

Form for Signature of Interviewing Officer

I, ______________________________________, a duly sworn peace officer and member of the __________________________________________ Department, ________________________, have asked that ______________________________________, a student in the ____________________________________________________ RISE Charter School, be made available for interview

Date: __________________              Signature: _________________________________________

Time: __________________              Badge Number: _____________________________________

School Action

Date and time parents notified. If more than one attempt is made, include such information here:

_____________________________________________________________________________________________________________________________________________

 _________________________________________

            Signature of Administrator
 

One copy each shall be made for:

1. School records;
2. Parent mailing;
3. The police officer; and
4. The witnessing administrator