Moral Reconation Therapy
This form is intended to serve as notice to Des Moines Municipal Court-Support Services your interest in one of the divisions MRT Programs.  By filling out this form-you are making the first step in securing a waitlist position in the chosen program.  A member of the Support Services Team will contact you within 2 business days to complete the waitlist procedures.
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Email *
Course you wish to join *
Last Name, First Name *
Date of Birth (MM/DD/YY) *
Phone Number *
Email *
Court *
Case Number *
Defense Attorney and Probation Officer (If Applicable)
A copy of your responses will be emailed to the address you provided.
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