Court Diversion Program for Youth Referral Form

To send a referral to spcaLA’s Court Diversion Program for Youth, complete and submit this form in its entirety. Upon receipt of referral, spcaLA’s Violence Prevention & Humane Education Department will determine eligibility and contact the parent/guardian for enrollment. Staff will contact you/the referring party first if any additional information is needed, if the referral cannot be accepted, or if this is your agency’s first time sending us a referral. For additional information, you may contact us 562-216-2545 or humaneeducation@spcala.com.
  • Date Format: MM slash DD slash YYYY

  • Date Format: MM slash DD slash YYYY