CHILD'S NAME: ____________________________________________________

CASE NUMBER: ____________________________________________________

TERM OF PROBATION ________________________MONTHS

CONDITIONS OF PROBATION

You have been placed on supervision because the Court believes you can, with the help of your Probation Officer, stay out of trouble. Supervision is for those who are willing and able to be helped and who can be trusted to make a real effort to help themselves. It is for the young person who cooperates and who is honest and sincere.

As part of your responsibility in the supervision plan, the Court is requiring you to carry out certain rules which the Court feels will be helpful to you. Your regulations during the time you are on supervision will be as follows:

1.	You are to obey all town, city, county, state and federal laws and ordinances, and you shall be guilty of no acts of bad conduct of any kind of character.
2.	You shall report to the Probation Department at such time and places as directed. Any changes of address, school, or employment must be reported to the Probation Department within five days.  
3.	Permit the probation officer to make visits at home or elsewhere to the extent necessary to supervise probation.
4.	Submit to warrantless searches of your person, property, residence, motor vehicle and effects at the request of your probation officer and consent to the use of anything seized as evidence in court proceedings.
5.	Refrain from possessing a firearm or other dangerous weapon.
6.	Refrain from having in your body the presence of any drugs prohibited by law. Whenever directed by a law enforcement officer or probation officer, you shall submit samples of blood, breath and urine to be tested, at minor's expense, for the presence of alcohol and drugs.
7.	You are to participate in programs and activities specifically assigned and outlined as part of your supervision program.
8.	You are to obey your parents at all times and have their permission for any activities that require you to be away from home.
9.	You are to be in the confines of your home by_____________________P.M., unless you are
in the presence of one of your parents or with the prior approval of your parent and Probation Officer.
10.	You are to be very careful as to the people with whom you associate, and you shall not associate with any persons who are in any sort of trouble with the law. You shall not attend places of ill repute.
11.	You are to attend school regularly with no absence or tardiness of an unexcused nature, and you shall diligently apply yourself to your school work and conduct yourself according to school policy. If you are suspended from school, you shall spend the term of your suspension, or an equal amount of time in detention at the Vigo County Juvenile Center. If you are out of school, you are to find suitable employment with reasonable hours.
12.	You are to make restitution in the amount of $__________________to__________________ 
_______________________________________, Payable as follows____________________
13.	SPECIAL TERMS: __________________________________________________________
___________________________________________________________________________
You are entitled to have a formal hearing by the end of the expiration of eighteen months, or earlier if justifiable reasons exist, to determine whether or not your rules of conduct herein should continue, be discontinued, or be modified. Remember that the Court and its Probation Department are at all times ready to assist you in any way possible.

DATE:______________________________			_______________________________

                                                                                                               Juvenile Magistrate

I have read the above Order of Supervision and had it explained to me. I agree to abide with the terms therein. I understand that failure to obey these rules will be noted, that the fact will be recorded, and that my supervision may be revoked.

DATE:______________________________			________________________________

 										Probationer

The undersigned, being the parents, guardian, or custodian of the child under supervision, hereby consent( s) to the above Order of Supervision. We further agree to participate fully in any supervision program and shall keep the Probation Department informed of the child's progress and any problems or violations, which occur.

DATE:______________________________			________________________________
       Parent, Guardian, or Custodian

DATE:______________________________			________________________________
       Parent, Guardian, or Custodian

I have on the _____________________ Day of_______________________________,2004,
read, explained and delivered a copy of the above Order or Supervision to the juvenile and his/her parent, guardian, or custodian.

DATE:______________________________			_________________________________

Probation Officer