Epstein Secrets

ne only) te Both Parents 0 Mother 0 Father 0 Foster 0 Group Home 0 Student is ward of the state Ot

been arrested resulting in a charge. of applicable 10. AInd with whom the student lives (check one only) te Both Parents 0 Mother 0 Father 0 Foster 0 Group Home 0 Student is ward of the state Other 11. IMPORTANT, EVERYONE MUST ANSWER THIS QUESTION. A. Is there a visitation order or other court

r Plan? (I Medi& provides copy) P650 0636 (Rev. oit2smos) pap 1 of 2 EFTA01710075 LEGAL NAME pea( 6* t .,, fS " b. Disclosures for entry into Palm Beach County School District (check all that apply) 0 The student has had juvenile justice actions taken against him/her. 011ie student has been expelled from school. 0 The s

ck one only) Both Parents 0 Mother 0 Father 0 Foster 0 Group Home 0 Student is ward of the state O

if checked provide a copy) PBSD 0636 (Rev. 01/26/2005) page 1 of 2 EFTA01710040 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 stud

ck one only) Both Parents 0 Mother 0 Father 0 Foster 0 Group Home 0 Student is ward of the state O

if checked provide a copy) PBSD 0636 (Rev. 01/26/2005) page 1 of 2 EFTA01727093 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 stud