M E M O R A N D U M 

O: 

 
 
 
FROM: 

Court Referral Education Program Directors 
Court Referral Education Instructors 
Non-Profit Alcohol/Drug Abuse Program Directors 
 
Cheryl Plato-Bryant, State Coordinator 
Alabama Court Referral Programs 

ATE: 

December 20, 2010 

E: 

New Program Application 

As  provided  by  Section  32-5A-191(c)  and  Sections  12-23-1  through  12-23-19, 
Code of Alabama, 1975, the Administrative Director of Courts is authorized to contract 
with agencies or entities to  conduct the court  referral education programs in each court 
jurisdiction  of  the  state.    At  this  time,  the  Administrative  Office  of  Courts  (AOC)  is 
soliciting  applications  for  an  education  program  provider  to  cover  Madison  County  in 
compliance with §12-23-4(a), Code of Alabama, 1975.   

It is the policy of the AOC to carefully select agencies to replace those that are no 
longer providing court referral services.  Consideration will be given to existing certified 
court referral education programs and other programs that are legally incorporated, non-
profit  alcohol/drug  abuse  or  governmental  agencies  existing  within  the  counties  to  be 
served.    In  the  event  that  no  qualified  agency  exists  or  is  willing  to  assume  these 
responsibilities,  other  appropriate  agencies  in  neighboring  counties  will  be  contacted  to 
determine the feasibility of their providing the services. 

If your agency is interested in providing the education services for these counties, 
you  must  submit  a  completed  application  and  checklist  to  this  office  no  later  than 
January 7, 2011.  Incomplete applications will not be accepted.  Enclosed you will find 
an application form and checklist.  If you have questions, do not hesitate to contact Millie 
Fuller at 1-866-954-9411, extension 5198. 

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APPLICATION  FORM 
(FOR COURT REFERRAL EDUCATIONAL PROGRAMS) 
 

omplete the following: 

1.  Name and address of organization. 

2.  County for which application is made. 

3.  Describe the current services this organization provides. 

4. 

Provide an organizational chart of the agency, including Board of 
Directors or other lines of authority.  
*Note that the Program Director may not serve on the Board of Directors. 

5.  Designate the individual who would coordinate the court referral 

program and include a resume.  Also include brief resumes of 
individuals who will serve as instructors. 

6.  Describe how the Court Referral Education Program could enhance 

current services provided by this agency. 

7.  Describe the location and physical facilities in which the Level I, II, 

and/or Youth and Juvenile programs would be held. 

8.  Describe the agency's policy on staff participation in training events. 

9.  Describe any current work applicant agency does with area courts. 

0.  Briefly describe why this agency should provide the Court Referral 

Education Program(s). 

 

Return to: 
 
Administrative Office of Courts 
300 Dexter Avenue 
Montgomery, Alabama  36104 
 
ATTENTION:  State Coordinator of Court Referral Programs 
 

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COURT REFERRAL PROGRAM 
CHECKLIST 

omplete and submit the following checklist to the Administrative Office of Courts on 

or before January 7, 2011.  
Please note that contracts can not be considered unless all information is complete.  
(Attach additional sheets where necessary.) 

. 

NEW PROGRAM (for first time applicants only) 

___  1)  Submit a completed application form.  

(If you are not a first time applicant, no action is required in this section) 

I. 

PROGRAM (for existing programs)  

___  1)  Submit a current copy of the agency's policies and procedures. 

___  2)  Submit a copy of your IRS non-profit certification. (non-governmental 
            agencies only) 

___  3)  List counties and courts to be served in each county 

___  4)  List programs/services offered by your agency.  Include targeted 
  

population(s), cost, and funding source(s).  

___  5)  Submit a copy of the agencies annual audit conducted by a certified public 
accountant and conducted in accordance with generally accepted auditing 
  
standards.  (audit should cover previous year)     
  

 

___  6)  Submit proof of Dishonesty Bond and Liability Insurance in the amount 
  
 

specified by contract.     

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age Two 

II.  FACILITY 

___  1)  Provide the physical address, mailing address, telephone number, and 
facsimile number of each facility utilized by this agency including the 
  
  
administrative office.  
 

2)  Submit a brief description of each facility used to conduct the Level I, II, 

and 

Youth & Juvenile Court Referral Education Program(s).  

___  3)  Are the facilities structurally sound, handicapped accessible, and maintained 
  

according to all federal, state, and local requirements for safety?  

___  4)  Identify the equipment and its' condition available for use in the support of 

the 
programs/services provided. 

V. 

PERSONNEL 

 

___  1)  Submit a current agency organizational chart (include title and name).    

2)  Submit a list of all employees: full-time, part-time, and independent 
contractors  (names, title, address, phone number, certification, continuing 
education credit, etc.). 

     
____  3) Submit a current list of Board Members (include: length of appointment, 

office 
held, meeting dates, and specific functions). NEW LIST REQUIRED BY ALL 
PROGRAMS         

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GENERAL 

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____  7)  Submit a proposed semi-annual schedule of classes including time and 
  

location. 

1)  Strengths and Weaknesses -- Provide a summary of each program component 
and describe the areas you believe to be areas of strength and the areas you 
believe to be weaknesses.   

___  2)  Provide your proposal for addressing the areas you have identified as 
  

weaknesses and your corrective action plan. 

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