Community Service Application

Please fill out this application if you need to complete court-ordered community service hours.

Date(Required)

Name(Required)

First Last

Physical Address(Required)

City State ZIP Code

Email(Required)

Phone(Required)

Emergency Contact Name(Required)

Emergency Contact Phone(Required)

Are you 16 years old or older?(Required)

Yes

Please note that any person under the age of 16 must be accompanied by a parent or guardian at all times for safety reasons.

What offense has required you to perform community service?(Required)

How many total hours of community service do you need to perform?(Required)

Do you intend to complete all hours of service at C.A.R.E.?(Required)

Yes

If no, how many hours do you intend to complete at C.A.R.E.?

What is the deadline for completion of your community service?(Required)

By typing your name below, you are stating that you have filled out this application survey honestly and to the best of your ability. Type your name:(Required)