Chapter XXVIII: Section 5: (3) of the Act shall be in the form of the Schedules appended

hereto.

SCHEDULE A.

PREVENTION OF CRIME ACT, 1908. _No._

(8 Edw. 7. Ch. 59.)

CRIMINAL JUSTICE ADMINISTRATION ACT, 1914.

(4 & 5 Geo. 5, Ch. 58.)

Order for Discharge on Licence from a Borstal Institution.

PRISON COMMISSION,

Home Office, Whitehall,

...... day of ...... 19..

The Prison Commissioners, in pursuance of the powers conferred upon them by the Prevention of Crime Act, 1908, do by this Licence permit ......, who at the ...... held at ...... on the ...... of ......, 19.., for the ...... of ...... was convicted of ...... and was sentenced to detention in a Borstal Institution for a term of ...... years, and is now detained in the Institution at ......, to be discharged from the said Institution within thirty days from the date hereof on condition that he places himself under the care, supervision and authority of the Honorary Director of the Borstal Association, until the expiration of his sentence on the ...... of ...... 19.., and during the further period of one year for which he is liable by the said Act to remain under supervision, namely until the ...... day of ...... 19.., unless the Prison Commissioners sooner revoke or alter this Licence.

This Licence is granted subject to the conditions endorsed hereon, upon the breach of any of which it will be liable to be revoked or forfeited.

_Secretary, Prison Commission._

Conditions.

1. The Licensee shall proceed to 15, Buckingham Street, Strand, W.C. and shall not without the consent of the Society or person under whose charge he has been placed, remove from that place or such other place as may be named by the Society or person.

2. He shall obey such instructions as he may receive with regard to punctual and regular attendance at employment or otherwise; he shall report himself periodically, either personally or by letter, if required to do so; he shall not change his address without permission.

3. He shall abstain from any violation of the law, shall not associate with persons of bad character, and shall lead a sober and industrious life to the satisfaction of the Borstal Association.

Attention is directed to the following Provisions of "The Prevention of Crime Act, 1908."