Tell Your Story - Juvenile Justice

Juvenile's Demographics

What is your relationship to the child involved with the justice system?

	Parent
	Grandparent
	Uncle
	Aunt
	Cousin
	Brother
	Sister
	Other:

What year was the child born?

What is gender of the child?

	Male
	Female
	Transgender

What is the Race/Ethnicity of the child?

	African-American or Black
	Latino/Latina or Hispanic
	Caucasian or White
	Asian or Pacific Islander
	Native American
	Other:

Does the child identify as one of the following?

	Bisexual
	Gay
	Lesbian
	Other:
	N/A

Section 1: Introductory Questions

1. At what age did the child have his/her first interaction with the juvenile justice system?

2. Where did this interaction take place?

	School
	Neighborhood
	Other:

3. What happened to result in his/her discipline?

4. What reasons did the school/police/etc., give for the specific disciplinary actions taken against your child?

5. Was your child warned before his/her first interaction with the juvenile justice system? If so, was it a written or verbal warning?

6. In this first interaction, with the juvenile justice system, was your child cited or arrested?

7. Has your child's experience been with the juvenile justice system or as a minor tried as an adult, or both?

8. Please tell us about the most recent incident that resulted in the child's involvement with the juvenile or adult justice system:

Section 2: Juvenile Court Process

9. Please identify and describe any problems that you encountered during the court process. These encounters could include any problems you may have had with:

	The courtroom work group (i.e., defense attorney, prosecutor, and judge)
	The probation officers assigned to the child's case
	The clarity of the courtroom process
	The helpfulness of everyone involved in the child's case

Section 3: Residential Placement

10. Was the child placed in a “residential placement facility” such as a group home, a pre or post adjudication facility, or a prison (juvenile or adult)?

11. Please identify and describe any problems that you had while the child was held at this facility. These encounters could include any problems you may have had with:

	Contacting the child by telephone
	Visiting the child
	Involvement in treatment
	Accessing information about the child's treatment
	The helpfulness of the staff at that facility

Section 4: Re-entry or Returning Home

12. Please identify and describe any problems that you had concerning the child's return home. These encounters could include any problems you may have had with:

	Discussion(s) or planning of the child returning home with staff at the residential facility
	The helpfulness of the planning/discussion(s)
	Fees associated with the child's involvement with the justice system after he or she has been/was released
	Assuring the child's education
	The helpfulness of professionals to assure the education of the child

Section 5: Supporting the Child Involved with the Justice System

13. Please identify and describe any problems that you had in an attempt to support the child. These encounters could include any problems you may have had with:

	Distance of facility from your home
	Loss of work time to deal with proceedings or to visit the child
	Advice from professionals (i.e., teachers, child welfare, service provider, etc) suggesting that the justice system is the best fit for the child
	Feelings of being discriminated against due to race, religion, gender, sexual orientation, or immigration status
	Inadequate treatment for the child due to mental health issues, substance abuse problems, or learning disabilities

Section 6: Identifying Solutions

14. Please identify and describe ways in which the juvenile justice system could improve in order to provide better treatment to the children they serve.

15. When there are good opportunities, we are interested in connecting willing families with members of the press who are writing about juvenile justice system issues. Would you be willing to speak to members of the press? If so, please make sure to enter your contact information.

Story Teller's Demographics

If you would like to obtain information regarding policy, legislation, and/or resources that may help you or your child in dealing with this difficult time, please provide the following information so that we may contact you at our earliest convenience:

	* Required information
First Name:	*
Last Name:	*
Address 1:
Address 2:
City:	State:
Zip/Postal Code:	*
Phone Number:
Fax number:
Other (pager, mobile, etc.)
E-mail address: