Community Service Application

(Worcester, Wicomico and Somerset Counties only)

Personal Information

Name: *

First*

Last*

Email: *

Cell Number:

Date of Birth: *

Emergency Contact Information

Name:

First

Last

Cell Number:

Relationship:

Probation Information

Probation Officer's Name:

First

Last

Probation Officer Telephone Number:

Extension:

Probation Officer Email:

Case ID Number:

Please explain the reason you have to do court-ordered Community Service, specifying the charge or violation you went to court for. *

Was the crime committed in Maryland? *

YesNo

If no, please specify the location where the crime was committed (City & State):

The amount of hours needed: *

Completion Deadline Date:

Please upload a copy of your photo ID: * (File size limit: 5MB)

Please upload documentation for court appointed community service: * (File size limit: 10MB)

Availability

Please specify your available days:

Store Location you prefer: *

Hours you prefer:

Date that you can start:

Do not enter anything here.