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2. First Name*
3. Last Name*
5. Address*
7. City*
8. State*
9. Zip Code*
11. Phone Number*
13. Email Address
15. Please Select: (Court Official Use Only)

    1. Plea Arraignment
    2. Bench Trial
    3. Review

    Please select what you are attending court for today.

17. District Court Attendee*

    1. If defendant leaves court, a Failure to Appear Warrant will be issued for Defendants' arrest, suspended Driver's license, a separate fine, and possible jail time.
19. Review: *

    1. I have read and understand the terms
21. Electronic Signature*
22. Date*
24. Page

26. Once form is complete, you may enter the  court room. 

    
    

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28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field