13.07.2015 Views

Community Accountability Programs Information ... - Ministry of Justice

Community Accountability Programs Information ... - Ministry of Justice

Community Accountability Programs Information ... - Ministry of Justice

SHOW MORE
SHOW LESS
  • No tags were found...

You also want an ePaper? Increase the reach of your titles

YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.

QUARTERLY DATA COLLECTION FORMName <strong>of</strong> program: _____________________________________________________________Mailing address: ______________________________________________________________Telephone numbers: ( )_________________ Fax Number ( ) ____________________Email: ______________________________________________________________________Contact name:________________________________________________________________Quarter: January-March April-June July-September October-DecemberYear: __________STATUS OF PROGRAM:Under development but hasn’t been implemented yetProgram plan complete Yes NoOperational(start date)_____________Other (specify)_______________________TYPE OF PROGRAM:CLIENTELE:Family Group Conferencing Youth Adults BothVictim Offender Reconciliation ProgramAGE RANGES:Neighborhood <strong>Accountability</strong> PanelCircle RemedyOther (specify) ____________________________Undetermined at this timeIF PROGRAM IS OPERATIONAL:List all referring agents:PoliceCrown counselJudiciarySchoolProbation OfficerCorrections contractorParentsOther (please specify) _____________Number <strong>of</strong> volunteers _______Number <strong>of</strong> volunteers trained _______Type <strong>of</strong> training provided (please describe)__________________________________________________________________________________________________________________________________________________________________________________________________Number <strong>of</strong> volunteers with criminal record checks_______Insurance coverageYes (please specify type) _________________________________NoPage 1 <strong>of</strong> 5

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!