Celebrating 10 Years of Serving Others

JCS PROGRAM REFERRAL FORM

Moral Reconation Therapy (MRT)
This program meets a minimum

of 12 sessions.

The cost of this program

is $240 (workbook

fee included).

Financial Management
This program

This program is a one day class. The cost of this program is $6.5 (workbook

fee included).

Restorative Justice (Thinking

& Building Bridges)

fee included).

is a one day class. The cost of this program is $6.5 (workbook

Anger Management (Coping With Anger)

This program meets

minimum

of 8 sessions.

The program

cosr is $210 (workbook

fee included).

Job Skills Workshop (JSW)

This program is a one day workshop. The program cost is $0 (workbook *Participants must be dressed as if going to job a interview* included).

Additionaiinformation: Case Number:

---------------------_

Offense:

--------------------------

Return Court Date:

SO ORDERED THIS

DAY OF

, 2011

Defendant

Municipal Court Judge

*************** Do Not Write below JCS Official Only ****************

PLEASE PRINT Defendants Name: _

o
DOB:

Accusations/Citation _

Included _

Social Security Number

Address:

~-----~-----

Apt#:

City:

State:

Zip Code: _

Phone:

Probationer Appointment

#:
for Enrollment:

Court Record #: -----------------------

Sex:

Race:

Judicial

Correction

Services 1631 Beacon Parkway W. Suite 1051 Birmingham,

AL 35209-6348 1205-942-9462

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CASE NO.

ORDER "The Defendant is hereby ordered to the following:

o
o

24 week JCS Domestic Violence Program ($650) 8 weekJCS Anger Management Program ($210) One Day JCS Financial Management Class ($65) JCS Restorative Justice Class ($65)
~'~~_---'I _ . _---,

I) One Day
1.

Within one week today's date, you will call the JCSProgram Coordinator, assessment. An additional fee will be due if an appointment is rescheduled.

to set up your initial

2.

You will attend each scheduled meeting. The fee for each group meeting is $25.00 per session (Domestic Violence & Anger Management Programs), which is due at the beginning of each session. You will purchase a handbook for use in the program. The Domestic Violence handbook is $25 and the Anger Management handbook is $10, payable at your first assessment. Defendant will also pay an initial $25 assessment fee for all Domestic Violence Program Classes. You will cooperate fully and honestly with the JCS program and follow each rule and recommendation staff. of the program and

3.

4.

You may have to meet other requirements, such as substance abuse or psychiatric evaluations in addition to attending your group meetings.

5.

You will not commit any acts of violence or abuse. All fees must be paid by cash or money order only.

Failure of the defendant to attend complete sessions or cooperate fully shall result in termination from the Domestic Violence Program and further action from the court. JCS will provide a completion summary to the court prior to your return court date
.; Of, ~ --'- __

Uefend~nt'~ign~tur;

Prosecutors Signature

Phone:

-------------------------

Work Phone:

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IN THE MUNICIPAL COURT OF BIRMINGHAM

BIRMINGHAM

vs.

CASE#

---------------------------

Defendant

MISDEMEANORiVIOLATION

PRE-TRIAL DIVERSION AGREEMENT

The Defendant is not eligible for the Misdemeanor Pre-Trial Diversion program if he/she has bee: charged with Driving While Under the Influence or Drug possession charges or previously convicted 0 a misdemeanor, violation or felony charges. By entering this agreement, the Defendant is ordered to comply with all terms as listed below for a tern of 6 to 24 months. Upon completion of said terms, this case will be nol prossed upon payment in full of all court costs. If the Defendant fails to comply, the Defendant will then enter a plea or guilty or not guilty and proceec with the case. If the Defendant enters a plea of guilty or is found guilty at the conclusion of a trial, the Defendant wil be sentenced in accordance with the law and/or fined. The Defendant will also be ordered to pa; applicable court costs. The Defendant may also be placed on probation and ordered to complete a set 0: court ordered terms.

The Defendant shall complete the following: 1. Defendant shall register to vote or provide proof thereof. 2. Defendant shall complete 30 hours of community service at a court approved location. 3. Defendant shall maintain employment, unless proven unable to work. 4. Defendant shall obtain/maintain a valid driver license. S. Defendant shall obey all local, state and federal Jaws, committing no new offenses. The Defendant shall also complete the following additional terms: o Defendant shall enroll in and complete a State Certified General Education Diploma or equivalent. o Defendant shall enroll in and complete a State Certified Vocational/Trade/College Program. o Defendant shall complete the following training classtes): o Moral Recognition o Job Skills o Defensive Driving or an equivalent o Financial Responsibility o Other:
*lfDefendant is ordered to complete a GED and/or vocational program, they may be responsible to pay up to six months of supervision fees.

ASSISTANT

CITY ATTORNEY

DEFENDANT

A TIORNEY

FOR DEFENDANT

DATE

JUDGE

TRACIE

A.

TODD

Date

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busiest court in Alabama

IN THE MUNICIPAL COURT OF BIRMINGHAM

BIRMINGHAM

vs.

CASE#

Defendant

MISDEMEANOR PRE-TRIAL DIVERSION AGREEMENT

The Defendant is not eligible for the Misdemeanor Pre-Trial Diversion program if he/she has been charged with Driving While Under the Influence or Drug possession charges. By. entering this agreement, the Defendant is ordered to comply with all terms as listed below for up to a 24 month period. Upon completion of said terms, this case will be nol prossed upon payment in full of all court costs. If the Defendant fails to comply, the Defendant will then enter a plea or guilty or not guilty and proceed with the case. If the Defendant enters a plea of guilty or is found guilty at the conclusion of a trial, the Defendant will be sentenced in accordance with the law and/or fined. The Defendant will also be ordered to pay applicable court costs. The Defendant may also be placed on probation and ordered to complete a set of court ordered terms.

The Defendant shall complete the following: 1. Defendant shall register to vote or provide proofofregistration (if eligible). 2. Defendant shall complete 30 hours of community service. 3. Defendant shall maintain employment, unless proven unable to work. 4. Defendant shall obtain/maintain a valid driver license. 5. Defendant shall obey all local, state and federal laws, committing no new offenses. The Defendant shall also complete the following additional terms: o Defendant shall enroll in and complete a State Certified General Education Diploma or equivalent. o Defendant shall enroll in and complete a State Certified Vocational/Trade Program. o Defendant shall complete the following training c1ass(es): o Anger Management o Defensive Driving or an equivalent o Job Skills o Financial Responsibility o Moral Recognition o Other:
ASSISTANT CITY ATTORNEY

DEFENDANT

ATTORNEY FOR DEFENDANT

DATE

JUDGE

Date