EXHIBIT
STUDENT INTERROGATIONS,
SEARCHES, AND ARRESTS
FORM FOR SIGNATURE OF
ARRESTING OFFICER
I, _______________________________________, a duly sworn peace officer and member of the _____________________________________________ Department, _____________________ division, have asked that _________________________, a student in the ________________________________________________________ School, be surrendered to me, and pursuant thereto have taken said student into my custody and am assuming full responsibility for the student's arrest.
Date ______________________ Signature _________________________
Time ______________________ Badge Number _____________________
School Action
Date and time parents notified (if more than one [1] attempt is made, include
such information here) ___________________________________________
______________________________________________________________
___________________________________
Signature of Administrator
1 copy for School Records
1 copy for Parent Mailing
1 copy for Police Officer
1 copy for Witnessing Administrator