Ninth Judicial Circuit AEP Application

Prior to submitting your application, you must call or email the AEP office to ensure we have received your referral from the court or prosecutor.
Call: 843-958-1930 or email: divservices@scsolicitor9.org

The AEP program is a privilege. Not everyone is offered this privilege.

Please take advantage of this opportunity to resolve the criminal charges pending against you at this time. Please note AEP is voluntary and your participation in this program is your decision. Failure to disclose pertinent information may result in your case being returned back to court or prosecutor.

Eligibility Check

Have you contacted our office to verify we received your referral from the court or prosecutor?

Yes

Have you ever applied, been rejected, or participated in any AEP before?

Yes

Have you ever been arrested or given a criminal citation, before the charge you are being referred to AEP on?

Yes

APPLICANT INFORMATION

Last Name

First

Middle

JR/III

Nickname/Alias

Maiden Name

SSN

Home Phone:

Cell Phone:

Street/P.O. Box

Apt#

City

State

Zip

Race

Gender

Date of Birth

Age

Birth State/Country

DL#

DL State

Do you have a CDL license?

Yes

Are you a US citizen?

Yes

Are you military, active or reserve?

Yes

Attorney Information:

No Attorney

Public Defender

Private Attorney

Attorney's Name:

Phone #:

Do you have transportation?

Transportation

Car

Family/Friend

Other

E-MAIL COMMUNICATION

Computer access?

Internet access?

BY PROVIDING MY EMAIL BELOW, I AUTHORIZE AND CONSENT TO COMMUNICATE BY EMAIL. IN AUTHORIZING EMAIL COMMUNICATION, I UNDERSTAND IT IS MY RESPONSIBILITY TO NOTIFY AEP STAFF OF ANY CHANGES TO MY EMAIL ADDRESS. I ACCEPT THE LIABILITY AND RISKS ASSOCIATED WITH THE USE OF EMAIL. I ALSO UNDERSTAND AEP CANNOT ACCEPT RESPONSIBILITY FOR ANY EMAIL MESSAGES NOT RECEIVED BY OR FROM YOU, OR FOR ANY DELAY IN THE RECEIPT OR DELIVERY OF ANY EMAIL NOTIFICATIONS. AEP IS NOT RESPONSIBLE FOR LOSS OF MESSAGES AND OTHER CONSEQUENCES FROM THE USE OF ELECTRONIC COMMUNICATION.

Your personal Email Address

SCHOOL/ EMPLOYMENT

SCHOOL INFORMATION

Name

Last Grade Completed

EMPLOYMENT INFORMATION

Name

Title/Position

AEP CHARGE INFORMATION

THIS INFORMATION IS NOT AN ADMISSION OF GUILT NOR IS IT ADMISSIBLE IN COURT FOR PROSECUTION OF THE CHARGE(S) PENDING AGAINST YOU.

PROVIDE THE TICKET #(S) AND CHARGE INFORMATION FOR THE CHARGE(S) YOU ARE APPLYING TO AEP ON:

Ticket Number	Charge	Police Department

CRIMINAL HISTORY INFORMATION

FALSE INFORMATION IN THIS SECTION WILL RESULT IN REJECTION OF YOUR APPLICATION OR TERMINATION FROM THE PROGRAM. THE APPLICATION FEE IS NON-REFUNDABLE.

LIST ALL PRIOR CHARGES AND/OR ARRESTS IN ANY STATE AND THE DISPOSITION OF THE CHARGE.

Date

State

Charge(s)

Disposition

Date

State

Charge(s)

Disposition

Date

State

Charge(s)

Disposition

Date

State

Charge(s)

Disposition

Date

State

Charge(s)

Disposition

Have you been charged with any crime since the incident for which you are applying for AEP?

Yes

Are you currently under investigation regarding any crimes?

Yes

Have you ever applied, been rejected, and/or participated in an Alcohol Education Program (AEP) in the state of South Carolina?

Yes

IF YOU ANSWERED YES TO ANY OF THE ABOVE QUESTIONS, PLEASE CONTACT THE AEP OFFICE TO DISCUSS YOUR ELIGIBILITY FOR THE PROGRAM.

I received this charge in (if not sure please call the office at 843-958-1902)

Charleston County

Berkeley County

CONTACT INFORMATION

I AUTHORIZE AND HEREBY CONSENT TO THE COMMUNICATION BETWEEN THE ALCOHOL EDUCATION PROGRAM AND MY CONTACT PERSON LISTED BELOW. THE COMMUNICATION MAY INCLUDE, BUT IS NOT LIMITED TO MY APPLICATION, PARTICIPATION IN THE PROGRAM, PROGRESS, AND DRUG TEST RESULTS .

CONTACT INFORMATION

Last Name

First

Middle

JR/III

Mailing Address

City

State

Zip

Home Phone

Cell Phone

Relationship to you

CHANGE OF ADDRESS/TELEPHONE NUMBER

(INITIAL) IF I CHANGE MY ADDRESS OR TELEPHONE NUMBER, I UNDERSTAND THAT IT IS MY RESPONSIBILITY TO NOTIFY ALCOHOL EDUCATION (AEP) AND THE COURT HANDLING MY PENDING CHARGE.

(INITIAL) I UNDERSTAND THAT ONLY THE COURT CAN GRANT PERMISSION FOR ME TO LEAVE THE STATE WHILE I HAVE A PENDING CHARGE(S). I UNDERSTAND THAT I MUST CONTACT THE COURT AND MY ATTORNEY FOR PERMISSION TO LEAVE THE STATE.

STATEMENT OF TRUTH AND RESPONSIBILITY

TO THE BEST OF MY KNOWLEDGE, I CERTIFY THAT ALL THE INFORMATION GIVEN ON THIS DOCUMENT IS TRUE AND ACCURATE. I HAVE NO PREVIOUS ARRESTS, CONVICTIONS, OR PENDING CHARGES THAT I HAVE NOT REVEALED IN FULL. I UNDERSTAND THAT ANY FALSE OR UNDISCLOSED INFORMATION MAY BE GROUNDS FOR MY REJECTION OR TERMINATION FROM THE PROGRAM. I UNDERSTAND THAT AEP WILL CONDUCT A CRIMINAL HISTORY INVESTIGATION. FURTHERMORE, I UNDERSTAND THAT FEES PAID TO THE ALCOHOL EDUCATION PROGRAM ARE NON‐REFUNDABLE.

BY CHECKING THIS BOX, I CERTIFY THAT THIS IS MY APPLICATION AND I AGREE TO THE TERMS ABOVE.

DEFENDANT'S SIGNATURE

To submit application please initial and date.

Initials:

Date:

Verification Code: