M-2 Volunteer Application

Your response to these questions will help us match you with an inmate in the M-2 Program.
 
First Name:
Last Name:
Address:
City:
State:
Zip:
   
Cell Phone: (XXX-XXX-XXXX)
Home Phone: (XXX-XXX-XXXX)
Work Phone: (XXX-XXX-XXXX)
   
Home Email:
Work Email:
   
Date of Birth: (MM/DD/YYYY)
Driver's License
Gender: Male   Female
Race: Black   White    Alaskan/Native    American Indian   Asian/Pacific   Other
Marital Status: Single     Married     Separated     Divorced
Employment:
Education:
Name of college: (if currently a college student)
   
Congregation:
City/State of Congregation  
Denomination:
   
Interests:  
    Hobbies:
    Sports:
    Reading:
    Community:
    Other:
   
Languages:  

Spanish   (If you speak other languages than English or Spanish, enter in Comments below)
   
Check the time and place you would like to visit. 
If you check more than one option, we will place you where most needed.
   

 

Hutchinson Correctional Facility - Central Unit
 (Visits are Tuesday evenings.  Arrive at 6:50 pm,; visit at 7:30)
First Tuesday of month
Second Tuesday of month
Third Tuesday of month
Fourth Tuesday of month
   
Hutchinson Correctional Facility - East Unit
 (Visits are the fourth Thursday.  Arrive at 6:45 pm,; visit at 7:15)
   
Hutchinson Correctional Facility - South Unit
 (Visits are the fourth Thursday.  Arrive at 7:00 pm,; visit at 7:15)
   
Special Needs:  If you have any special needs such as handicap accessibility, please enter in Comments.
   
Comments:
   
By submitting this form I agree to visit my M-2 friend once a month.
Confirm:   Enter your initials to confirm you are ready to submit this information.

 

Questions?  Contact M-2@offendervictimministries.org