Midland Teen Court, Inc.
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Midland Teen Court, Inc.
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M MIDLAND TEEN COURT COMMUNITY SERVICE CARD
Use this card to verify community service hours. Please complete all blanks.
NAME OF YOUTH: ______________________________________________________
I hereby certify that the above named youth has completed _________________hours of community service (or counseling) by performing the following duties:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________ AGENCY NAME PHONE NUMBER
_______________________________________________________________________ SIGNATURE of COMMUNITY SERVICE SPONSOR / AGENT DATE
NOTE: The youth with a case in Teen Court should have this card signed and return it to the Midland Teen Court Office, 615 W. Missouri, #226, upon completion. Questions? Contact the Midland Teen Court Office, 689-1065. www.midlandteencourt.org
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Send mail to
mbeck@midlandteencourt.org with
questions or comments about this web site.
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