Fill and Sign the Child Surrogate Form

––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– –– –– –– –– –– –– –– –– –– –– –– –– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– –– –– –– –– –– –– ––––– –– ––––– –– ––––– –– –– –– –– –––––CHILD'S ATTORNEY (Name and address): FOR COURT USE ONLY JV-535 TELEPHONE NO. (Optional): E-MAIL ADDRESS (Optional): FAX NO. (Optional): CHILD'S NAME: SUPERIOR COURT OF CALIFORNIA, COUNTY OF STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE: BRANCH NAME: ORDER LIMITING PARENTS 'RIGHT TO MAKE EDUCATIONAL DECISIONS FOR THE CHILD and RECOMMENDATION FOR SURROGATE PARENT APPOINTMENT- JUVENILE CASE NUMBER: 1. a. Date of hearing: Dept .: Roo m: b. Judicial officer (name): c. Persons present: Chil d Child's attorney Mothe r Mother's attorney Fath er Father's attorney Guardia n Deputy district attorney Probation officer/ social worker Deputy county counsel CAS A Othe r: 2. Child's name: Date of birth: 3. Child's school district: 4. Child's school (name and address): 5. Child's social worker: 6. Child's supervising social worker: 7. Child's probation officer: 8. After consideration of the evidence on such date, the court finds and orders under Welfare and Institutions Code section 361 (a) or 726: a. The right of the mothe r father mother and father guardia n to make educational decisions for the child i s is not specifically limited by this court. Parent(s) or legal guardian(s) whose right to make educational decisions for the child is being limited (name(s)): b . The following persons are within the definition of family or have the right to make educational decisions without surrogate appointments. Relative placement (name and address): Foster parent (name and address): c . A copy of this order and recommendation must be served on the local educational agency by: ( 1 )( 2 )( 3 ) a representative of the county welfare department. a representative of the county probation department. the clerk of this court. Attachments Page I of 2 Form Adopted for Mandatory Use Judicial Council of California JV- 535 [ JV-535 [Rev. January 1, 2007] Education Code, § 56156; Government Code, § 7579.5; Welfare & Institutions Code, §§ 361(a),726; Cal. Rules of Court, rules 5.695(c)(3), 5.790(f)(5), 5.650ORDER LIMITING PARENTS' RIGHT TO MAKE EDUCATIONAL DECISIONS FOR THE CHILD and RECOMMENDATION FOR SURROGATE PARENT APPOINTMENT-JUVENILE electronic form ã 2001-7 WWW.LawCA.com Law Publishers ––––– ––––– ––––– ––––– –––––––––– –––––CHILD'S NAME: CASE NUMBER: 9. The court requests that the local educational agency appoint a surrogate parent for the child under Government Code section 7579.5(b) and notify the court on the attached Local Educational Agency Response (form JV-536) within 21 calendar days from the date of the appointment. 10. The court recommends that the following person be appointed as the educational surrogate pursuant to Government Code section 7579.5: a. Recommended surrogate parent's name: b. Recommended surrogate parent's address: c. Recommended surrogate parent's telephone no.: d . Recommended surrogate parent's relationship to child: 11 - This order applies to any school or school district in the state of California. This form must be sent to the local educational agency with form JV-536, Local Educational Agency Response to JV-535- Appointment of Surrogate Parent. Dat e: JUDICIAL OFFICER Page 2 of 2 JV-535 [Rev. January 1, 2007] ORDER LIMITING PARENTS RIGHT TO MAKE EDUCATIONAL DECISIONS FOR THE CHILD and RECOMMENDATION FOR SURROGATE PARENT APPOINTMENT- JUVENILE