Get Greater Derry Juvenile Diversion Program - Urteachersorg

Filling out the Greater Derry Juvenile Diversion Program form online can help ensure a smooth enrollment process for your child. This guide provides clear, step-by-step instructions to assist you in completing the form accurately.

Follow the steps to complete the enrollment form.

1. Press the ‘Get Form’ button to access the form and open it in your preferred editing platform.
2. Begin by entering the date at the top of the form in the designated format: month/day/year.
3. Fill in the name of the youth in the provided field, ensuring you accurately input the date of birth and age next to it.
4. Provide the current address, including city or town, state, and zip code in the respective fields.
5. Enter your telephone numbers, including home, cell, and work, in the appropriate sections.
6. List the names of parents or guardians in the specified space.
7. Indicate who the youth resides with and the number of siblings they have.
8. Complete the school and grade sections, noting if the child has an IEP or 504 plan, and provide further details if applicable.
9. Detail any medications the youth is currently taking in the designated area.
10. Indicate whether the youth is currently in counseling and, if so, provide the counselor’s name.
11. Identify the referral source and their telephone number to ensure proper communication.
12. Specify whether the youth has a juvenile probation/parole officer (JPPO) and include their name if applicable.
13. Answer questions regarding any barriers to participating in the program and any recent major changes in the child's life.
14. Provide information on the incident as reported, choosing the appropriate party responsible for the incident report.
15. Fill in any additional information that the facilitators should know to assist your child’s success in the program.
16. Once completed, save the form, and prepare it for submission along with the non-refundable fee of $85.
17. Submit the form to the designated address noted at the top of the document.

Complete the enrollment form online today to ensure your child can participate in the Greater Derry Juvenile Diversion Program.