Mt.

Morris Consolidated Schools Tier 2 Check-in/Check-out (CICO)

Student: ____________________________________________ Date: ________________

Teacher: ____________________________________________ School: _Montague____

3 2 1

Comments:
BE BE BE see Teacher Comment Key below
Times SAFE KIND RESPONSIBLE
successes 5-Point Feeling Scale

123 123 123

123 123 123

123 123 123

123 123 123

29 or more =
TOTALS /12 /12 /12 /36 1 PRIDE ticket

Facilitator: ___________________________ Check-in:_______ Check-out:_______

Teacher Comment Key:

1. Respect others’ personal space 7. Allow other students to learn
2. Use materials appropriately 8. Solve conflicts with others peacefully
3. Use kind words and a respectful tone 9. Cope with strong feelings in a healthy way
4. Complete tasks 10. Take responsibility for your choices
5. Try your best 11. Ask for help when needed
6. Follow directions the first time

Parents, please sign, date, and return to school. Thank you!

Signature: ______________________________________ Date: ________________

Parent Comments:

________________________________________________________________________________

________________________________________________________________________________

Updated (3-21-17)