Complete the form to get started with community service

I must perform my Community Service Hours at a government or non-profit agency, other than my place of employment. NO OTHER COMPENSATION FOR THESE HOURS CAN BE GIVEN.

Non-emergency CELL PHONE CALLS are NOT permitted at a worksite.

Uncooperative attitudes will be cause for removal from the program.

I understand that I must perform a minimum of 5 hours per week.

Program fees must be paid in full at the time of enrollment and are NOT REFUNDABLE.

I understand that I must perform my community service hours and return the timesheet to MLAS by the Required Completion Date. Failure to do so WILL result in my case being sent back to the sentencing agency. AN ADDITIONAL FEE WILL BE REQUIRED TO RE-OPEN THIS CASE AT A LATER DATE if not completed on time.

It is my responsibility to track and report my completed hours to MLAS prior to my completion date by FAX, MAIL, OR PERSONAL DELIVERY.

I will be on time and keep a regular schedule with my assigned agency.

I will notify MLAS of any change in my address or phone number.

I will follow the instructions of my supervisor at the worksite. I will notify MLAS if there are any problems with my work assignment.

I will not drink alcohol or use drugs (Including Medical Marijuana) before or during my work hours.

I will not bring a dog or any kind of animal to the worksite. 

I will not bring alcohol or drugs (Including Medical Marijuana) to the worksite.

I will not bring weapons (Including pocket knives) to the worksite.

I understand that I cannot change my worksite without approval from MLAS staff. Hours performed at unauthorized agencies will not be credited. 

A fee of $25 will be assessed in the event of a re-assignment to a different worksite. 

A fee of $25 is required for extensions to the original Completion Date.

I authorize my doctor to release medical information about my physical or mental limitations for the purpose of arranging my placement if needed.

I understand visitors are not permitted at my worksite.

I agree to work without pay as a condition of the Court order and, because I am not an employee of MLAS or of the community service site, I will not be covered by insurance for any injury(ies) received on this assignment. I understand I have no right to claim compensation for any accident and/or injury from MLAS, the Service Site I am assigned to, or any of their officers, agents, or employees, and against said Court, its judges and employees, and the County of Lake and the County of Mendocino.

I understand I must seek medical treatment on my own if I am injured while performing my community service obligation and REPORT IT TO MLAS PROMPTLY.

I understand that it is my responsibility to provide proof of enrollment to the Court when required. Failure to do so may result in a warrant for my arrest.

RETURNED CHECKS will be assessed a $75 SERVICE CHARGE.