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THE SCHOOL DISTRICT OF PALM BEACH COUNTY DEPARTMENT OF SAFE SCHOOLS SchoolBased Stay Away Agreement This agreement is to be completed with school administration in a conference with the alleged aggressor.

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How to fill out the School Stay Away Agreement online

Completing the School Stay Away Agreement online is a vital step in ensuring a safe educational environment. This guide provides a clear and supportive walkthrough to help you fill out the form accurately and efficiently.

Follow the steps to fill out your School Stay Away Agreement

  1. Press the ‘Get Form’ button to access the School Stay Away Agreement form and open it in your preferred online editor.
  2. Fill in the student ID number at the top of the form. This helps in identifying the student involved.
  3. Enter the last name and first name of the student clearly in the designated fields.
  4. Select the school name from the dropdown menu or enter it if required manually.
  5. Input the date of the incident and any corresponding notifications to the parent or guardian in the respective fields.
  6. Document the date of the conference held with the parent or guardian to discuss the situation.
  7. Describe the relationship between the involved parties briefly and accurately.
  8. Indicate whether a court order for protection has been issued between the two parties by selecting 'Yes' or 'No'.
  9. For the alleged aggressor's name and the victim's name, fill in both names as required, ensuring clarity.
  10. Specify the distance that the alleged aggressor agrees to stay away from the student victim, using 'feet' as a measurement.
  11. Detail any methods of communication that the alleged aggressor must refrain from using with the student victim.
  12. Include any changes to schedules or extracurricular activities that may affect the agreement, specifying changes in arrival and departure times.
  13. Complete the section on additional staff notifications and any other disciplinary actions that may have been taken.
  14. Sign and date the agreement at the indicated fields. Ensure that both the student and administrator’s signatures are collected.
  15. Review the document for accuracy, ensuring all fields are filled properly, then save, download, or print the form as needed.

Complete your School Stay Away Agreement online today to promote a safe and supportive school environment.

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The intent of this agreement is to increase safety for students who have been the target of severe or repeated bullying, sexual harassment or dating violence. It is to be administered by the Principal or the Principal's designee in a conference with the offending student and his or her parent.

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