codeforamerica / intake

A Django project behind the Clear My Record website
https://clearmyrecord.codeforamerica.org
MIT License
52 stars 23 forks source link

Build Demo Site (pre-approved) #1225

Closed sarahlizwhite closed 7 years ago

sarahlizwhite commented 7 years ago

Key: R = required/missed question will error out application O = optional/applicant can submit without completing question

  1. How would you like Clear My Record to update you about your application? (R)
  2. What is your first name? (R)
  3. What is your middle name? (O)
  4. What is your last name? (R)
  5. Any other names that might be used on your record? (O)
  6. What is your phone number? (R)
  7. What is another phone number we can reach you at? (O)
  8. What is your email? (R if they choose to be contacted by e-mail.)
  9. Where is a safe place you can receive mail? (R)
  10. What is your date of birth? (R)
  11. What is your drivers license or ID number? (if you have one) (O)
  12. What is your Social Security Number? (if you have one) (O) ^^For 12. help text needs to be amended to be broader than just SF. Current text reads: "The public defender's office will use this to get your San Francisco record and find any convictions that can be reduced or dismissed."
  13. What is your case number, if you know it? (O)
  14. Are you currently being charged with a crime? (R)
  15. Are you currently serving a sentence? (R)
  16. Are you on probation or parole (including MSR or PRCS)? (R)
  17. If you are on probation or parole, which counties is it in? (O)
  18. If you are on probation or parole, when does it end? (O)
  19. Have you ever been arrested or convicted in any other counties? (O)
  20. If you were arrested or convicted in other counties, which ones and when? (O)
  21. Do you owe any court fines or fees? (R)
  22. Are you currently employed? (R)
  23. What is your monthly household income? (R)
  24. Where does your income come from? (R)
  25. How much money do you have saved? (R)
  26. NEW In the last 12 months, have you received any funds such as lawsuit money, a tax refund, and/or pension fund? (enter amount)
  27. Are you on any government benefits? (R)
  28. How much do you spend each month on things like rent, groceries, utilities, medical expenses, or childcare expenses? (R)
  29. Do you own a home or rental property? (R)
  30. Do you have children? (R)
  31. How many people depend on your financial support? (R)
  32. Are you married or in a legal domestic partnership? (R)
  33. Why are you applying to clear your record? (O)
  34. How did you hear about this program or website? (O)
  35. Is there anything else you would like us to know? (O)
  36. Do you understand that not everyone qualifies for help, submitting this form does not guarantee that you will be represented by one of our partners, and it might take a few months to finish? (R)
  37. Do you understand that attorneys in the counties you have selected need to access your criminal record and file petitions for you? (R)
  38. In [county list], do you understand that attorneys need to attend court on your behalf, even if you aren't there? (R)
sarahlizwhite commented 7 years ago

@TiffanyAndrews @jazmynlatimer will you please look at question 26?