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Juvenile Center Detention/Intake Form

  1. Juvenile Center Detention/Intake Form
  2. Where:
  3. Offense Type
  4. Fingerprinted?
  5. Can Be Released:
  6. Cannot Be Released Because:
  7. Electronic Signature Agreement
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
  8. Leave This Blank:

  9. This field is not part of the form submission.