E.J.M.E.S.

Peer Mediators: #1 _______________________ #2 _______________________

What was conflict about? Pushing/Cutting Teasing Game Property Friendship Other
Student #1 agreed to: Student #2 agreed to:
Go to another game Ignore it Go to another game Ignore it
Share & take turns Apologize Share & take turns Apologize
Tell them to stop Talk it out Tell them to stop Talk it out
Make a Deal Walk away Make a Deal Walk away
Wait & Cool Off Other Wait & Cool Off Other

Was the conflict resolved?: YES NO
Student #1 Signature: _____________________ Student #2 Signature: _____________________




E.J.M.E.S.

Peer Mediators: #1 _______________________ #2 _______________________
What was conflict about? Pushing/Cutting Teasing Game Property Friendship Other
Student #1 agreed to: Student #2 agreed to:
Go to another game Ignore it Go to another game Ignore it
Share & take turns Apologize Share & take turns Apologize
Tell them to stop Talk it out Tell them to stop Talk it out
Make a Deal Walk away Make a Deal Walk away
Wait & Cool Off Other Wait & Cool Off Other

Was the conflict resolved?: YES NO
Student #1 Signature: _____________________ Student #2 Signature: _____________________