Juvenile Justice
ORGANIZATIONSec Immunization Guidelines for School and Child Care Facilities
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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
with their current Florida school, fill in boxed areas below and complete Part A-2 on the reverse side of this form. • For additional information: Sec Immunization Guidelines for School and Child Care Facilities for information and instructions on form completion and immunization requirements. Guidelines are updated annually and arc available from the local
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
with their current Florida school, fill in boxed areas below and complete Part A-2 on the reverse side of this form. • For additional information: Sec Immunization Guidelines for School and Child Care Facilities for information and instructions on form completion and immunization requirements. Guidelines arc available from the local county health department.
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
with their current Florida school, fill in boxed areas below and complete Part A-2 on the reverse side of this form. • For additional information: Sec Immunization Guidelines for School and Child Care Facilities for information and instructions on form completion and immunization requirements. Guidelines arc available from the local county health department.
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