Name
Address	Street City State Zip
Phone	Day Evening
Email
Class Preference	Saturday 10am-1pm (Up-County Regional Services Center)
How do you wish to be contacted?	Phone Email
How did you hear about us?	CHOICES Flyer District Court Judge Alternative Community Service Office Private Attorney Other
What is your charge? (check all that apply)	Possession of alcohol by a minor Furnishing/Selling alcohol to minors Possessing False Identification Other