Public Safety Education Department
Student Coaching & Counseling Reply
Must be completed and returned to the issuing instructor the next class meeting.
Student Name: Date:
My perception of the pr
My awareness of the seriousness of the problem:
Steps I will i
mplement to correct the problem:
Educational Coordinator Signature__________________________________
This form is due by the next class period or within three days of issuance of the
Public Safety Education Student Coaching & Counseling form.
Public Safety Director notified: yes no
Distribution: Student/Student’s File
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