Student: ________________________________________________________________________________
Teacher: ________________________________________________________________________________
Date: ___________________________________________________________________________________
Students who access restricted items on the Internet are subject to the appropriate action described in the school's discipline policy or student handbook or to the following consequences:
___________ First Offense
The above student has violated the Student Internet Policy by intentionally accessing restricted material. He/she may lose Internet access for up to six weeks. A
second offense will result in the student losing Internet access for the remainder of the school year.
___________ Second Offense
The above student has violated the Student Internet Policy by intentionally accessing restricted material for a second time. As a consequence of this violation the
above student has lost Internet access for the remainder of the school year.