Court Appointed Volunteer Application
If you have been appointed by the courts to complete volunteer service hours, disABILITYsa has various opportunities to serve. We offer both in-person and virtual opportunities that will be determined on a case-by-case basis.
Contact Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
*
-
Month
-
Day
Year
Date Picker Icon
Age
*
Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Address
*
City
*
Zip Code
*
Back
Next
Save
Emergency Contact
Name
*
First Name
Last Name
Relationship
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Back
Next
Save
Service Details
Number of Hours Needed
*
Deadline to Complete the Hours?
*
-
Month
-
Day
Year
Date Picker Icon
Days Available for Service
*
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Time Frame(s) Available
*
8:00 AM - 12:00 PM
1:00 PM - 5:00 PM
5:00 PM - 7:00 PM
Please upload an official document that states TOTAL # OF HOURS you were ordered to complete
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please upload an official document that states OFFENSE you have been charged with
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
If it was not provided in the documents uploaded above, upload your time keeping sheet. If you don't provide it here, disABILITYsa will provide one for you instead.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Save
Submit
Should be Empty: