Follow the steps to fill out the form accurately and thoroughly.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your last name, first name, and middle name in the designated fields. If applicable, indicate Jr or III.
3. Fill in your social security number, ensuring the format is clearly followed with dashes.
4. Provide your cell phone number in the next field.
5. Enter your address, including street number, P.O. Box, apartment number, city, state, and ZIP code.
6. List any maiden names or nicknames you may have, along with your race and sex.
7. Input your birth date and the state where you were born.
8. Provide your driver’s license number and the state it was issued in.
9. List all addresses where you have lived over the past two years in the specified section.
10. Indicate your citizenship status by checking 'Yes' or 'No' and specify if you are military, active, or reserves.
11. If you are a U.S. veteran, include the approximate date of discharge.
12. If you have an attorney regarding the PTI charge(s), provide their name in the space provided.
13. Check the box that applies to your marital status and employment situation from the list provided.
14. Report your household income by selecting the appropriate range from the provided options.
15. State whether you are currently a full-time or part-time student, and if applicable, provide the name of the institution you are attending.
16. List your employment status, job title, location, and duration of employment.
17. Answer the questions regarding previous PTI applications or alcohol education programs, if applicable.
18. If you have any pending criminal charges in other courts, include details.
19. Describe the criminal charges that led you to apply for PTI.
20. In your own words, explain how the incident occurred.
21. Answer the questions regarding the involvement of firearms and whether your family is aware of your PTI arrest.
22. Indicate whether you were detained at jail on this charge and if a bond was paid.
23. If applicable, list any previous arrests or citations, excluding minor traffic violations.
24. Provide information about your household members and their ages.
25. Indicate if you were the primary caregiver for children in your home at the time of arrest.
26. Evaluate your general health, financial situation, and family status.
27. If you are on any medications, provide the details, including the medical reasons.
28. Mention any past counseling you have undergone, along with reasons and duration.
29. If you have been placed in a hospital or residential program for substance abuse or emotional issues, describe that.
30. Outline your goals for the PTI program.
31. Sign and date the application, verifying the accuracy of the information provided.
32. Ensure all required documents, including ID, social security card, and application fee, are prepared for submission.

Complete your application online and ensure all necessary documents are submitted for successful processing.