....................Prosecutor

of.........................................

......................Accused

of .........................

(Parent of the said child)

of .........................

WHEREAS PROCEEDINGS entitled as above, under section 17 of the School Attendance Act, 1926, against the above-named parent with respect to the above-named child, who *is *appears to be aged ....... years, having been born *so far as has been ascertained) on the ...... day of ................ 19..... and who resides at .................................... in the area of the ................. Health Board and in the said court district, ARE TO-DAY BEFORE THE COURT,

THE COURT *(being satisfied that the said parent has used all reasonable efforts to cause the said child to attend school in accordance with the said Act of 1926,)

*(having convicted the said parent of a second subsequent offence under the said section 17 in respect of the said child,) and

having heard the said health board and being satisfied that the welfare of the child so requires,

HEREBY ORDERS that the said child ..................................

be committed to the care of the ............. Health Board—

*(for so long as he/she remains a child, that is to say, until the ..... day of ................ 19.....)

*(for the period from the ...... day of ............. 19..... until the ..... day of .............. 19.....)

*(for the period from the date upon which the child is delivered into the custody of the board until the ..... day of ............... 19.....)

*(AND DIRECTS as follows:—

.)

Dated this.............. day of................... 19.............

Signed ..................

Judge of the Children Court

* Delete words inapplicable