THANK YOU FOR AGREEING TO FILL OUT THIS FORM.

This study is to find out the educational background of people who come before Magistrates Courts. The NSW Law Reform Commission and the University of Sydney are collecting the Information. The results will help the Law Reform Commission to understand the difficulties people face when they go the court. Then the Commissio can decide if things need to be changed, to make the court process better. That will help everyone. There is another way you can be helped. If this form shows anything that needs to be followed up by your solicitor, that information will be passed on to your solicitor.

PLEASE FILL IN ALL THE ANSWERS TO THE QUESTIONS BELOW. IF YOU HAVE ANY PROBLEMS, ASK FOR HELP FROM THE PERSON WHO GAVE YOU THE FORM.

Surname ________________________________________

Other names______________________________________
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Date of Birth __________	Age_____
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Are you (please tick) Male ____ Female _____
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Are you (please tick) Aboriginal, Korri _____
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..Islander _____ None of these _____
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Were you born in Australia? Yes ____ No ____
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If no, where were you born? _________________________
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What grade were you in when you left school? ___________
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What was the last school you went to? _________________
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How many different schools did you go to? ______________
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Were you ever in a special class? Yes _____ No _____
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If yes, what was the name of the school? ________________
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Were you ever in an OA of OF class?
No _____ OA _____ OF _____
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Are you working or unemployed?
Working _____ Unemployed _____
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If working what work do you do? ______________________
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Full-time or Part-time work? Full _____ Part _____
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Do you get a pension or benefit? Yes _____ No _____
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If yes, tick what type
Unemployment _____
Disability Support (Invalid Pension) _____
Sickness _____
War _____
Other (write in) ________________________________
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Have you ever been on a pension of benefit in the past?
Yes _____ No _____
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If yes, tick which type
Unemployment _____ Sickness _____ War _____
Disability Support (Invalid Pension) _____
Other (write in) ________________________________
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Are you at court today because you are charged with an offence? Yes _____ No _____
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Are you charged with more than one offence? Yes _____ No _____
How many? _____
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What is the most serious charge? (write in) ____________________
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What are the other charges? _______________________________
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Are you at court for any other reason today? __________________
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Have you ever been charged with an offence before?
Yes _____ No _____
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How many offences? (please tick)
1
2
3
4
5
6
more than 6
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What offences were they? ________________________________
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Do you have a lawyer? (please tick)
No _____ Legal Aid _____ Private Solicitor _____
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Please write in the name and telephone number of your solicitor:
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Name: ________________________________________________
Telephone Number: _____________________________________