Statute Intake Form

CVJP can help you navigate your pending criminal case.

Please add your information to this form

so we can help you for free.

What is your housing situation?

Stable Housing

Homeless

At risk of homelessness

What is your employment situation?

Employed

Unemployed and searching

Unemployed by choice

Retired

Do you have access to transportation?

Yes, I have a car

Yes, public transit

No

Release of Information

By checking this box I acknowledge that I received CVJP’s Personal Information Policy and that I understand and agree to the terms and conditions, including CVJP’s collection, storage, tracking and dissemination of my personal information within the CVJP program, people/entities CVJP is seeking help for me with, and program funders.

Personal Information Policy found: Here

Thanks for submitting!

Personal information Policy

During the intake process and throughout the program, Community Veteran Justice Project (CVJP) will collect certain personal information from you. The information is necessary for us to run our program, receive funding, improve our services, better understand your needs and obtain services for you.

We will only collect information that is necessary to achieve those goals and will not share it outside of the CVJP project, people/entities we are seeking services for you, and funders without your consent or authorized by law. In order to protect your rights and privacy we keep all forms secured in locked file cabinets with the addition of these forms emailed to our executive director and the supervisor to track on a tracking form and database to insure you have received the services and referrals, so cases can be tracked for any follow thru. The information gathered is used by internal case management staff to maximize service delivery to our clients. Additionally, the information gathered is shared to evaluate and improve service delivery. In order to receive and maintain funding, CVJP may share information, including personal information with our program funders. No information gathered is shared with any other external entity than mentioned above.

Personal Information Policy

Don't have a phone?

TAG Mobile Lifeline Assistance Program is a government-assisted free cell phone service that provides discounted cell phone services to eligible low-income families and individuals. Lifeline Services discounts are offered to qualified customers who meet certain eligibility requirements such as, government assistance or a household income that is at or below 135% of the federal poverty level. Customers get benefits of free minutes and free texts every month. We have nationwide coverage to serve you with the lifeline program. We offer services in Arkansas, Arizona, California, Colorado, Iowa, Kentucky, Louisiana, Maryland, Maine, Michigan, Minnesota, Missouri, Nevada, Oklahoma, Pennsylvania, South Carolina, Texas, Wisconsin and West Virginia. Visit https://www.tagmobile.com/ for more information and to enroll today!

Clients MUST have phones in order to coordinate effectively and receive help.