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nDESIGNATING EDUCATIONAL RIGHTS HOLDER

JV-535(A). CASE NUMBER: CHILD'S NAME: General Information 1. Child's or youth's date of birth: 2. School information a. School district: b. School (name and address): c. Foster youth EDUCATIONAL liaison (Ed. Code, ) (name and contact information): d. The child is currently expelled from school and may be eligible for readmission on or after (date): 3. Regional center (name and address): Service coordinator (name and contact information): 4. County placing agency (specify): a. Assigned social worker or probation officer (name and contact information): b. Supervising social worker or probation officer (name, address, and contact information): 5. Child's or youth's attorney (name, address, and contact information): THE COURT FINDS AND ORDERS. 6. The child or youth is the subject of a petition filed under section 325.

School information. 3. 2. 1. Child's or youth's date of birth: c. b. a. Page 1 of 2 . Form Approved for Optional Use Judicial Council of California

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