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he student ever been e,pelled from school? 0 0 2. Has the student ever had an arrest resulting in a charge? 0 0 3. Has the student ever had any Juvenile Justice actions? (31) CUSTODY STATUS OF STUDENT (check one) • Mother 0 Father El Shared Custody 0 Other MN Is there a court order barring either paren
ing the school day? .0 YES 0 NO If YES, provide the school with a copy of the court order. PESO 0636 (REV. 5/29/2001) page 1 of 2 EFTA01709611 THE SCHOOL DISTRICT OF PALM BEACH COUNTY - NEW AND RETURNING STUDENT REGISTRATION (36) FATHER OR LEGAL GUARDAN first rmcWe Hap SAD IIIIIII IIIII PU: Y giimOR4211 OR LEGAL GUARDIAN (last mAMM
40 STUDENT LEGAL NAME MN Rat middle) 9. Disclosures for entry into Palm Beach County School District (check all that apply) O The student has had Juvenile Justice actions taken against him/her. 0 The student has been expelled from School O The student has been arrested resulting in a charge. Ef Not applicable
dent during the school day? U YES Wil0 provide the sotto& with a copy of the court order. PBSD 0636 (REV. 02/04/2002) page t o12 EFTA01710055 THE SCHOOL DISTRICT OF PALM BEACH COUNTY - NEW AND RETURNING STUDENT REGISTRATION v - ! -. an k C A- t STATE ZIP COCE pa d 6. FL d3V I1 On l0Jtii Palm STATE ZIP CODE PL 334 1 ' 0OCU
93 STUDENT LEGAL NAME MN Rat middle) 9. Disclosures for entry into Palm Beach County School District (check all that apply) O The student has had Juvenile Justice actions taken against him/her. 0 The student has been expelled from school O The student has been arrested resulting in a charge. ErNot applicable
dent during the school day? U YES Wil0 provide the sotto& with a copy of the court order. PBSD 0636 (REV. 02/04/2002) page t o12 EFTA01727108 THE SCHOOL DISTRICT OF PALM BEACH COUNTY - NEW AND RETURNING STUDENT REGISTRATION I I- an - kOODUP eVitt Palm STATE ZIP COCE bud', FL 83Y 1 L CITY ..„ al m iatieeh a STATE ZIP COD
Entities connected to both Juvenile Justice and THE SCHOOL DISTRICT OF PALM BEACH COUNTY - NEW
Legal Authority
ORGANIZATIONLeon Black
PERSONPermanent Medical Exemption
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Medicaid
ORGANIZATIONFCAT Mathematics
ORGANIZATIONMathematics Scale Scores
ORGANIZATIONPhysical Education
ORGANIZATIONFlorida Comprehensive Assessment Test
ORGANIZATIONCoast Guard
ORGANIZATIONSec Immunization Guidelines for School and Child Care Facilities
ORGANIZATIONAir Force
ORGANIZATIONData Analysis
ORGANIZATIONthe Career Exploration Scores
ORGANIZATIONThe Military Careers Score
ORGANIZATIONThe Military Entrance Score
ORGANIZATIONthe Sunshine State Standards
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Vince Foster
PERSON
Samantha Power
PERSONthe Coast Guard
ORGANIZATIONClinic Na
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