Clone of Homeowner Document Upload Form

Court-Ordered Community Service Application

For our records, please complete the following in regards to your offense and the hours to be served. This is for our records only and will be kept confidential.
Date

MonthDayYear
Name
E-mail
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Are you 18 or older?
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Number of Hours Required
Deadline
Type of Offense
Court Name/Address
Court Contact
Contact Phone
Case and/or citation #
Upload Documents Here

If you have documents from the Court or your attorney, please upload them here.
Cancelof
Comments
Having been required by law to complete community service, I do hereby acknowledge that I have received a copy of, read, and understand Syracuse Habitat for Humanity's Guidelines for Court-Ordered Community Service. I also affirm that I will abide by the aforementioned Guidelines. I confirm that everything in this application is true to the best of my knowledge.
Signature
Should be Empty:

Court-Ordered Community Service Application