Court Appointed Community Service Information
Date______/______/_______
Name:__________________________________________________________________
Local Address:___________________________________________________________
City:_____________________________________State:___________Zip:____________
Permanent address:________________________________________________________
City:_____________________________________State:___________Zip:____________
Home phone:____________________________Cell:_____________________________
Email:__________________________________________________________________
Are you at least 18 years old? (please circle)
Y
N
If you are not 18 you must tell the person giving the orientation and complete Jr. Liability release
Emergency contact: (Name)_____________________________________(relation)____________________
Phone:_____________________________________________________________
Required Court Contact Information
*Offense:______________________________________________________________
Offense = what you got the ticket for
Court:
Justice of the Peace, Name___________________pct #___________
College Station Municipal Court, Kenek Tap Rd
Bryan Municipal Court
Other:__________________________________________________
Court Phone #:________________________________________________________
Number of hours Required:____________________deadline:______________________
*required before leaving orientation.
Update:07/21/09
Over 