Exit Survey JDCAP - Alternatives to Detention Question Title * 1. Please provide the demographic information below. Your information will not be shared, but may be used if additional follow up questions are necessary. Thank you! Name: Company: Address: Address 2: City/Town: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Email Address: Phone Number: Question Title * 2. Which of the detention or detention alternative services below does your office use? Juvenile Detention Shelter Evening Reporting Electronic Monitoring In-home detention Weekend programming Temporary Foster Care Other (please specify) Question Title * 3. Please provide the main contact information for each service listed above. Name: Company: Address: Address 2: City/Town: State: ZIP: Country: Email Address: Phone Number: Contact Person: Agency Name: Agency Address: Contact Phone Number: Contact email address: Question Title * 4. Please provide the main contact information for each service listed above. Name: Company: Address: Address 2: City/Town: State: ZIP: Country: Email Address: Phone Number: Contact Person: Agency Name: Agency Address: Contact Phone Number: Contact email address: Question Title * 5. Please provide the main contact information for each service listed above. Name: Company: Address: Address 2: City/Town: State: ZIP: Country: Email Address: Phone Number: Contact Person: Agency Name: Agency Address: Contact Phone Number: Contact email address: Question Title * 6. Please provide the main contact information for each service listed above. Name: Company: Address: Address 2: City/Town: State: ZIP: Country: Email Address: Phone Number: Contact Person: Agency Name: Agency Address: Contact Phone Number: Contact email address: Question Title * 7. Please provide the main contact information for each service listed above. Name: Company: Address: Address 2: City/Town: State: ZIP: Country: Email Address: Phone Number: Contact Person: Agency Name: Agency Address: Contact Phone Number: Contact email address: Question Title * 8. Please provide the main contact information for each service listed above. Name: Company: Address: Address 2: City/Town: State: ZIP: Country: Email Address: Phone Number: Contact Person: Agency Name: Agency Address: Contact Phone Number: Contact email address: Question Title * 9. Please provide the main contact information for each service listed above. Name: Company: Address: Address 2: City/Town: State: ZIP: Country: Email Address: Phone Number: Contact Person: Agency Name: Agency Address: Contact Phone Number: Contact email address: On behalf of JDCAP members, thank you for your time and effort! If you have questions or additional information you wish to share, please email Wayne Bear at wbear@pacounties.org. Done
