THE SCHOOL DISTRICT OF PALM BEACH COUNTY
RESEARCH AND EVALUATION
Affidavit of Good Moral Character
The purpose of this affidavit is to present evidence of good moral character in order to conduct research in the
School District of Palm Beach County.
By signing this document, I swear that I have not been found guilty or entered a plea of guilty or nolo contendere
(No Contest), regardless of the adjudication, to any of the following charges under the provisions of the Florida
Statutes or under any similar statute of another jurisdiction. I also attest that I do not have a delinquency record
that is similar to any of these offenses:
Sections:
741.30
782.04
782.07
782.071
782.09
784.011
784.021
784.03
784.045
787.01
787.02
787.04
794.011
Domestic violence
Murder
Manslaughter
Vehicular homicide
Killing an unborn child by
injury to the mother
Assault, if the victim of offense
was a minor
Aggravated assault
Battery, if the victim of offense
was a minor
Aggravated battery
Kidnapping
False imprisonment
Moving children from the state
or concealing children contrary
to court order
Sexual battery
Chapter: 796
Section: 798.02
Prostitution
Lewd and lascivious behavior
Chapter: 800
Section: 806.01
Lewdness and indecent behavior
Arson
Felony theft and/or robbery
Chapter: 812
Section: 817.563 Fraudulent sale of controlled
substances, if the offense was a felony
Chapter: 825
Relating to adult abuse, neglect, or
(previously 415.111) exploitation of
aged persons or disabled persons
Sections: 82604
827.03
827.04
827.05
827.071
Incest
Aggravated child abuse
Child abuse
Negligent treatment of children
Sexual performance by a child
Chapters: 847
893
Obscene literature
Drug abuse prevention and control
(only if the offense was a felony or if
any other person involved in the offense
was a minor)
Print Name
Signature of Applicant
Date
State of
County of
Subscribed and sworn before me on this
day of
, 20
at
.
Personally known
OR produced identification
Type of identification
PBSD 2356 (Rev. 12/10/2015)
Signature of Notary Public
Commission expires on
ORIGINAL - Research and Evaluation
COPY - Signee