Participatory Defense Intake Form 

Participatory Defense is a community organizing model for people facing charges, their families, and communities to impact the outcome of cases and transform the court system's power landscape. 

The information collected below will be used to research a criminal case in public records so that our PD organizers can identify Points of Intervention.

Should you need more information, please reach out to our Organizing Manager:

 Dianna Williams - dwilliams@grassrootsleadership.org

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Type of case *
How were you referred to the Participatory Defense Program? *
If "Other" was selected for the previous question please explain
Your First Name *
Your Last Name
Your Contact Number *
Your Email Address
Relation To Accused Person *
If "Other" was selected for the previous question please explain
Accused Person First Name *
Accused Person Last Name *
Accused Person Date Of Birth *
MM
/
DD
/
YYYY
Accused Person Phone Number
Date Accused Person was arrested
MM
/
DD
/
YYYY
Accused Person SPN # or TDCJ #
Accused Person Booking # or SID #
Accused Attorney Name
Accused Attorney Phone Number
Representation Type
Clear selection
Charge Type
Charges being brought against Accused Person
Case or Cause Number
Arresting Agency
Jail Being Held In
Bond Amount
Clear selection
What factors are preventing the Accused Person release?
If you answered "other" to the previous question please explain
How are you willing to support the Accused Person? Please select ways willing to support.
Type of support you are looking to get from group
Case Status
Clear selection
Have you ever been arrested on a cite and release eligible charge? (Example: Any class C misdemeanor except public intoxication, Poss of marijuana less than 4oz, Theft of property less than $750,  Theft of service less than $750, Driving while license invalid, Graffiti).
If so what was it and when did it occur?
What was the outcome of you being charged with a cite and release offense?
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