State of Alabama Unified Judicial System Form JU-31 Rev. 1/09 Case Number NOTICE TO SUPERINTENDENT OF SCHOOL DISTRICT OR PRIVATE SCHOOL PRINCIPAL IN THE JUVENILE COURT OF _________________________________________ COUNTY, ALABAMA (Name of County) In the Matter of ______________________________________________________________________, a child Pursuant to Ala. Code 1975, §12-15-217, this notice is for the purpose of informing you that ____________________________________, date of birth ___________________, a child enrolled in the ____ grade in __________________________________________school, has been adjudicated delinquent of the offense of _______________________________________ in violation of Ala. Code 1975, § _________________________ . This offense is classified as a Class ____ felony; misdemeanor. A brief description of the offense found to have been committed by the child is as follows: The Juvenile Court of _________________________ County made the following disposition on this offense: ____________________ Date ___________________________________________________ Signature and Title Any information received by a teacher, counselor, administrator or other school employee pursuant to Ala. Code 1975, §12-15-217 shall be received in confidence for the limited purpose of rehabilitating the child and protecting students and staff, and shall not be further disseminated by the teacher, counselor or administrator, except insofar as communications with the child, his or her parent, legal guardian, legal custodian. law enforcement personnel and the juvenile probation officer of the child if necessary to effectuate the rehabilitation of the child or to protect students and staff. An intentional violation of the confidentiality provisions of this section is a Class A misdemeanor under the jurisdiction of the juvenile court. Ala. Code 1975, § 12-15-217 American LegalNet, Inc. www.FormsWorkFlow.com