HARNETT COUNTY VETERANS TREATMENT COURT, DISTRICT 12

Who can apply?

The justice-involved veteran, their defense attorney, arresting officer, correctional officer, magistrates, prosecutors, judges, or anyone that comes in contact with the veteran at any point in their legal process, prior to sentencing. You do NOT need to have a Harnett county case to apply. We are regional and serve all surrounding counties.

Download PDF Version

Download

First name*

Last name*

Birthday*

Month

Day

Year

Phone number*

Charge*

Your most recent charge.

County of Charge*

The county in which you were charged for the mentioned offense.

County of residence*

The county your home address is located in.

Are you on probation or parole?

Yes

No

Date of probation/parole

Military Branch

MOS

Military occupational specialty

Highest Rank Obtained *

Dates served

Discharge Status

Did you serve in a combat zone? if yes, give location and dates.

Have you been homeless since leaving the military?

Yes

No

Are you enrolled in VA care?

Yes

No

Do you have a disability rating?

Yes

No

Current rating

Do you have reliable transportation?*

Yes

No

Can you access your DD214?

Yes

No

Defense attorney name and contact information

Additional comments

QUESTIONNAIRE

You're halfway there!

What happens now?

Your questionnaire will be entered into our case management system and passed to the DA's office for approval or denial. For more on the application and admission process, click here.

bottom of page