MONTHLY REPORT TO PROBATION OFFICER-JUVENILE

NAME:_____________________________________________________________ TELEPHONE:______________________________

ADDRESS:________________________________________________________________________________________________________

                                Street                                                       City                                         County                    State                        Zip

MAILING ADDRESS IF DIFFERENT:____________________________________________________________________________________________________

NAME OF SCHOOL:_____________________________________________________________________ GRADE:_____________

Name of Probation Officer­­­­­­­­­­­­­­­­:________________________________________________________________________________________

Have you had any tardies, unexcused absences, detention or office referrals, etc., at school?     NO               YES, this is what happened: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Please attach copies of any progress reports or report cards received since last reporting.

Do you have a job?   No                    YES, I am working __________ hours per week at_________________________________________ doing ____________________________ earning _________________

Have you been in any trouble or had contact with a law enforcement officer since you last reported?    NO   YES, this happened:_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Please write a brief paragraph explaining what activities you have been doing since you last reported.  ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Are you attending counseling or the teenage drug and alcohol class?    NO        Yes         If yes, please give dates and times:________________________________________________________________________________________________________________________

Do you have community service hours?    NO                        YES       If you have not completed them, please explain.  ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Parent comments:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Questions or Additional Comments:  ________________________________________________________________________________________

IF YOU NEED FORMS, PLEASE PROVIDE A SELF-ADDRESSED STAMPED ENVELOPE.

DATE:  _____________________________       SIGNATURE:____________________________________________________________

SEND OR BRING THIS REPORT WHEN DUE TO:                     Glenn County Probation Department

     Juvenile Division

Phone:  530-934-6416                                                                                       541 W. Oak Street

                                                                                                                                                   Willows, CA  95988