Worksheet For Individual Proposed Parenting Plan Page 3
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4This list is for the children named:
.
(A)
Education
Shared
%
Petitioner
%
Respondent
%
(B)
Non-Emergency Health Care
Shared
%
Petitioner
%
Respondent
%
(C)
Religion
Shared
%
Petitioner
%
Respondent
%
(D)
Child Care
Shared
%
Petitioner
%
Respondent
%
(E)
School Related Activities
Shared
%
Petitioner
%
Respondent
%
(F)
Shared
%
Petitioner
%
Respondent
%
(G)
Shared
%
Petitioner
%
Respondent
%
PARENTS' CURRENT WORK SCHEDULES
List your current work schedule. Complete only the part on your work schedule.
Petitioner's Work Schedule
Respondent's Work Schedule
CHILDREN'S SCHOOL, AFTER SCHOOL, & SPORTS ACTIVITIES
List your children's current school, after school activity, and sports schedules. School includes
pre-school and kindergarten programs. Explain when and how the children go to school and other activities,
and when and how they come home. (If you have filed an Affidavit To Withhold Identifying Information, then
you do not have to list your children's school.)
None of our children attend school, pre-school, or kindergarten.
This list is for the children named:
.
SCA-FC-128: Worksheet for Individual Proposed Parenting Plan
Page 3 of 4
Review Date: 05/2014; Revision Date: 05/2014;
WVSCA Approved: 06/17/2014
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