COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. : CASA VOLUNTEER PREFERENCE FORM JUDICIAL SUBPOENA Plaintiff(s) -against: Volunteer Name: ____________________________________ Please check preference in each section. : : GENDER: q Female Defendant(s) : . . . . . . . . . . q. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Male q Either AGE: THE PEOPLE OF THE STATE OF NEW YORK q TO q q q Any Birth to 5 6 to 11 12 to 18 GREETINGS: GEOGRAPHIC LOCATION: q Farmington WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before q Aztec , the Honorable Bloomfield/Blanco at the Court q County of q Shiprock/Kirtlandlocated at in room , on the day of , 20 , at o'clock in the noon, and at any recessed q Any or adjourned date, to testify and give evidence as a witness in this action on the part of the PREFER NOT TO WORK WITH THIS ABUSIVE SITUATION: q Abandonment q Educational Neglect Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party onq Emotional this subpoena was issued for a maximum penalty of $50 and all damages sustained as a whose behalf Abuse result of your failure to comply. q Medical Neglect q Physical Abuse Witness, Honorable , one of the Justices of the q Physical Neglect q Sexual Abuse Court in County, day of , 20 q None PREFER NOT TO WORK WITH THIS DISABILITY: (Attorney must sign above and type name below) q Cerebral Palsy q Hearing q Learning Disabilities Attorney(s) for q Mental Retardation q Mobility q Neurological q None Office and P.O. Address q Other q Psychological q Reactive Attachment Disorder Telephone No.: q Respiratory Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com