Application for Community Service

Name(Required)
Gender(Required)
Address(Required)

Emergency Contact

Name(Required)

Community Service Information

Probation Office Address(Required)

Community Service Period

Availability

(Please list the hours you are available. Use N/A to indicate the day(s) you will not be available. Note: Community service hours are to be completed Monday through Friday, during regular business hours. Weekend or alternative hours must be approved by an administrator.

Code of Conduct - Community Service

Please read each section carefully and initial in the space provided. Check that you understand and agree to abide by the rules, regulations, and responsibilities as a community service participant with NAMI Central Georgia, Inc.(Required)

Responsibility

As a community service participant at NAMI Central Georgia, Inc. I understand that all matters concerning residents, staff, and other consumers are completely confidential. I also agree to follow NAMI Central Georgia, Inc. guidelines, rules, & regulations.
Name(Required)
Clear Signature
I have read and understand the code of conduct for community service participants. I pledge to maintain a level of professionalism during the completion of my community service hours