Peer Jury Program Juror Application

If you are applying in the middle of the school year, you may not be contacted until August of the next school year.

School

Primary Phone Number

Please handwrite a brief paragraph about why you want to be a peer juror and upload a scan of the document.

Click Here to Upload

Parent/Guardian Consent Letter

Dear Parent/Guardian:

Your son/daughter has expressed an interest in becoming a Peer Juror. This program is under the auspices of local police departments. Jurors hear cases in which the offender has admitted guilt to committing an offense. Peer Jury cases are recommended by the responsible officer. The offender and his/her parent or guardian must sign a consent form to have the case placed before the Peer Jury.

Hearings will be once a month. They are held at the Arlington Heights Police Department. Please sign the form below if you agree to let your son/daughter participate in the program. Have your son/daughter return this application to the Peer Jury Coordinator at the Arlington Heights Police Department.

Please feel free to contact the Peer Jury Coordinator if you have any questions concerning this program.

Parent/Guardian Signature

First Name

Last Name

Choose how to sign

Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.

Parent/Guardian Primary Phone Number