Series 503.3.2.1P - Notice of Suspension, Grades K-5
Adopted: April 2007
To: (parent or guardian) ( ) (phone)
(address, zip code)
We hereby notify you that ,
(student's first name, middle initial, last name) (grade)
has been suspended from school. The suspension will begin on the following date:
at the following time: . This suspension is for day(s).
During the period of suspension, the student will not be allowed on the property of
this school or any other school in District 196. The suspended student may return to
my office on the following date: WITH/WITHOUT a parent or guardian.
_______ ( )
Administrator’s signature date phone
Reason for suspension, evidence and student statement:
/ / at : .
Parent of guardian notification:
o Notification by mail, sent at the following time and date:
(Required within 48 hours.)
o Contacted parent or guardian by telephone:
(Reasonable efforts must be made to contact the parent as soon as possible.)
o Your child has met the criteria for a violent student behavior notification as required by Minnesota Statute 121A.64. A confidential notice will be sent to
your child’s teacher(s). (Only applies to certain designated behaviors.)
o Student may be admitted back into his or her regular classes.
o Other (specify)
Enclosure: Minnesota Pupil Fair Dismissal Act
Distribution: parent or guardian attendance office cumulative folder student