REGISTRATION

Name *

First Name

Last Name

How can we reach you? *

Call/Text

Email

Are you an Imperial Courts resident? *

Yes

No

Review each eligibility risk below: *

check all that apply

You were convicted in a federal court

You were sentenced to time in a California state prison

You are still on probation and are unable to have your probation terminated early

You are currently facing charges with, serving a sentence for, or on probation for another criminal offense

You were convicted of certain sex offenses that involve children

None of the above eligibility risks apply to my case