22/23 Lunch Detention Request

Please complete this form in order to request a student to serve lunch detention. Entries will be sent directly to the staff overseeing lunch duty.

Name of Teacher Requesting: Name of Teacher Requesting: First Last
Teacher Requesting Email
Student Name: Student Name: First Last
Student Number:
Grade Level:

Grade Level: 6th 7th 8th
Today's Date: Today's Date: / MM / DD YYYY
Briefly explain the reason you are requesting this student serve lunch detention.
What steps were taken prior to requesting a lunch detention?
Date of Parent Contact/ Notification: Date of Parent Contact/ Notification: / MM / DD YYYY
Name of Parent/ Guardian Spoken to: Name of Parent/ Guardian Spoken to: First Last