COMPLETED APPLICATIONS are DUE March 29, 2008
The
Plymouth County Citizens' Trial Court Academy
sponsored by the Trial Courts of Brockton, Brockton
Community Policing Leadership Council, and the
Plymouth County District Attorney's Office is an
educational program that offers residents an
opportunity to learn about the different court
divisions of the Trial Court of the Commonwealth.
Please type
or print the application. Feel free to attach
additional information.
NAME:
____________________________________________________________
ADDRESS:
____________________________________________________________
(Number)
(Street)
(Apt.#)
____________________________________________________________
(City/Town)
(State) (Zip)
EMPLOYER
___________________________________________________________
OCCUPATION:
__________________________________________________________
WORK
____________________________________________________________
ADDRESS
(Number) (Street)
____________________________________________________________
(City/Town)
(State) (Zip)
TELEPHONE
_____________________________________________________________
(Home) (Work)
DATE OF
BIRTH: __________________________
Briefly
describe why you are interested in attending the
Citizens' Trial Court Academy.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Do you have
any matters presently pending before the Superior Court,
District Court, Probate and Family Court, Juvenile
Court or Housing Court? Yes___ No__
If yes,
please identify the name of the case and docket number.
___________________vs.____________________
Docket #_____________________
Applicants
will be notified upon acceptance
______________________________________________________________________________
Upon receipt
of an application, a criminal record inquiry will
be completed. The information obtained may result in
exclusion from the program. This information, along with
social security number, will be destroyed upon
completion of background check.
The signature
below verifies that all information is correct and
authorizes the criminal record inquiry.
APPLICANT'S
SIGNATURE: ____________________________________________
Social
Security Number:_________________
DATE:__________________________
Return this
application and authorization by March 29. 2008 to:
Citizens’
Trial Court Academy
Juvenile Court Clerk’s Office
PO Box 7398
215 Main Street, 2nd Floor
Brockton, MA 02303-7398
ATTN: Thomas
R. Lebach, Clerk Magistrate |
