For the offence(s) of ………… we are making a referral order for ………… months.
You will meet a panel of people who will be told of the following facts about your offending …………
They will then ask you to agree and sign a contract that will include activities to stop you offending again. The order starts on the day you sign the contract.
If you do not sign it, or do the things listed in it, you can be brought back to the court and given a different sentence.
[State names of parent(s)/guardian(s)/local authority representative(s)] ………… must also attend the meetings.
Your order will be supervised by the ………… Youth Justice Services.
You must also pay a surcharge of £…………
Do you understand?