Community Service Agreement - Valley County
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1COMMUNITY SERVICE AGREEMENT
VALLEY COUNTY COURT SERVICES
Name
Case No
________________________________
___________________________
Phone ___________________________
To be Completed By
_______________
(Please initial that you understand and agree to the Community ServiceTerms of Agreement)
____ 1. I accept my community service commitment voluntarily, and I agree to complete my hours within the time
ordered by the Court.
____ 2. I consent to the release of information regarding my criminal record to work sites if necessary only for the
purpose of placing me with a work assignment.
____ 3. I understand that it is my responsibility to contact an approved work-site that is a non-profit or a government
organization. Community Service for the elderly and/or disabled will be determined and approved by the Community
Service Coordinator. Contact the Community Service Coordinator for list of community contacts.
____ 4. I agree to keep any arranged work schedules made with the work site and am responsible to contact the work
site if I will be late, am sick or need to be excused from a scheduled work day. Failure to do so may result in termination
from the assignment.
____ 5. It is my responsibility to maintain a record of hours worked and report them to the Community Service
Coordinator at the McCall Courthouse Annex for verification on or before my deadline as set by the Court. I understand
that failure to meet these obligations by the completion date could be a violation of my terms of probation.
____ 6. I understand that hours worked and/or any corrections must be documented on the time sheet and signed by the
work site supervisor.
____ 7. I understand that NO community service work for a family member is allowed NOR are family members
allowed to sign my time sheet.
____ 8. I understand that the use of DRUGS and ALCOHOL WILL NOT BE TOLERATED while performing
community service.
____ 9. I Understand that on the job I will be neat and clean in appearance. My language and behavior will be polite and
considerate. I will follow the work site’s rules and supervision.
____ 10. I understand that I will not receive any kind of payment for any community service work.
____ 11. I understand I am responsible for my own transportation and child care.
____ 12. I am required to pay a Community Service Fee of $0.60 per hour of Community Service for Workman’s
Compensation Insurance which is included in my Court/Program fees/fines.
HOURS ORDERED ______ X $0.60 = _________
____ 13. I understand that I must report any physical or mental condition or impairment which might limit opportunities
for community service. If any, please list. ______________________________________________________________
Signed
Date
____________________________________________________
____________
Parent/Guardian
Date
_____________________________________________
_____________
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