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Document
Youth Intervention Network Referral Form
Get involved and help empower a family in crisis.  Download one of the referral forms above. Together we can change the lives of youth between the ages of 13 thru 18 who are likely to commit or become victims of violent crimes.   
 

Youth Intervention Network Threshold Criteria

1.    1.  Child must be between the ages of 13 and 18.


2.    2.  Must be a resident of Antioch, California, or reside within the geographic boundaries of Antioch Unified School District. (Some consideration will be given to families living outside the target area when children are attending Antioch Unified Schools.)


3.    3.  Legal guardians and students must agree to be fully engaged in process and cooperate fully with family advocates and meditative team.


4.    4.  Student must be enrolled in school or involved in a bona fide home school program unless student is working on a GED, or has received a high school diploma.


5.    5.  Must have completed referral form and have signed all releases of information.


6.    6.  Must return all documents by stated deadlines.


7.    7.  Must attend orientation and induction meeting.


8.    8.  Services needed/sought must be within the scope of services available through the YIN. (Excluded, (not offered), services include but are not limited to housing, diversion, food, clothing, money, and services already being provided to the family through the county.)  For questions about whether or not particular services are available please contact Iris Archuleta at 925-755-9291.


Note:  Although most referrals will come from Participating Agencies, Community Based Organizations, and Faith Organizations, a family may self-refer, or a referral will be accepted by a family friend or relative.


No consideration will be given to referrals without the signed consent of the parent or guardian of the youth being referred. (See the "Consent to Referral" portion of the referral form).

 




Youth Intervention Network Referral Process Instructions

Document
Referral Process 2009 - 10


The Youth Intervention Network is supported by (in alphabetical order): 

Antioch Chamber of Commerce
City of Antioch 
East Bay Community Foundation 
Emerald Consulting
Jaap van der Sar
John Muir Health
Pacific Gas and Electric
US Attorney's Office - Northern District
Vesper Society 



Emerald Consulting

Telephone:  (925) 755-9291 | Fax:  (925) 755-9292 

Fax:  (925) 755-9293


Email: iris@emeraldconsulting.com 

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