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2. Submitting your Pre-Trial Diversion request form is not a guarantee that you have been accepted into the Pre-Trial Diversion Program. Prior to your next scheduled court date, a profile history will be run and you will be contacted by our office regarding your eligibility.
4. Full Name*
5. Date of Birth*
   Date of Birth
7. Street Address*
9. City*
10. State*
11. Zip Code*
13. Phone Number*
14. Email Address*
16. Case Number*
17. Next Court Date
    Next Court Date
19. Do you have any previous convictions?*
    -- Select One --NoYes
20. Are you represented by legal counsel?*
    -- Select One --NoYes
Leave This Blank:


22. Submit

* indicates a required field