SELF-DISCIPLINE SHEET Student Name: (Please write First and Last Name) Rank: (At time of completion) Date: (When submitting paperwork) Graduation Date: (When award will be received) To Participate in our Self Discipline Program: ★ Write down something you did around the house or at school that you did not have to be told to do by an adult. ★ Bring your sheet to class when you have completed 10 lines completed and you will receive an attitude stripe. ★ Each student will receive a total of three stripes for completing this sheet. ★ Upon receipt of your third stripe, this sheet will be collected and you will receive a Discipline Award at the next Graduation. 1 6 2 7 3 8 4 9 5 10 Parent Sign/Date: Instructor Sign/Date: 1 6 2 7 3 8 4 9 5 10 Parent Sign/Date: Instructor Sign/Date: 1 6 2 7 3 8 4 9 5 10 Parent Sign/Date: Instructor Sign/Date: www.seosmartialartsacademy.com March 2014
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