Humes Preparatory Academy Middle School

Scholar Statement Form

Date

Scholars Name:

Grade Level
6 7 8

integrity (noun)

the quality of being honest and having strong moral principles; moral uprightness.
By submitting this statement, you are committing to providing an accurate and honest statement.
Remember, integrity is doing the right thing even when no ones watching.

Written Statement

Please provide a brief description what happened

Administrative Comments

Administrators Name: ___________________________________________________ Administrators Signature:________________________________________

Date: ______/______/__________