Respondent Pre / Post Test

What is your name?

Today's Date

Is this your Pre-Test or Post-Test?

For what type of offense were you referred to Peer Court?

If you had not been referred to Peer Court, or if you fail to complete the program, what kind of punishment or trouble will you be in?

Please list the people who were harmed or affected in a negative way by this incident:

Please explain how your school and/or community was harmed by this incident

Please explain how your family members were harmed or affected

If you have taken any steps to fix what you did or repair the harm you caused, please list them here