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FOR EMERGENCIES, PLEASE DIAL 911.
Child's First Name
Child's Last Name
Child's Birthday
Please briefly describe the behaviors exhibited by the child that have led you here today:
Your First Name
Your Last Name
Phone
Email
Street Address
City
Region/State/Province
Postal / Zip code
Country
Country
What applies to you?
My child is truant (5 or more unexcused absences/tardies), or has willfully and repeatedly violated lawful school rules
My child is ungovernable
My child is a runaway
My child has repeatedly possessed or consumed intoxicating beverages, misrepresented age, or repeatedly loitered in area of a liquor store
My child under 10 years of age has committed any act which if committed by an adult would be a crime under any federal, state, or local law
My child committed an offense applicable only to children
I had a caretaker who has caused, encouraged or contributed to the child’s behaviors, or to the commission of delinquent acts
I had a caretaker who has willfully failed to attend a meeting with the child’s teacher, school principal, or another appropriate school employee
I have a child who has been found incompetent to proceed with a delinquency matter
My child has been found to engaged in cyberbullying
SUBMIT
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