Name:
Norfolk Rank:
How many arrests do you have (estimated):
Are you currently in a criminal enterprise/gang:
How long ago was your last arrest (must be at least one week from application date):
Give a basic description of why you want this:
Give a basic description of how you've changed:
Will you consent to a one month probation period:
Signature
Lying on this form or violating probation will result in you being permanently barred from this program.
MLPBoyDan, Norfolk City Attorney |