Request edit access
I.E. Hospitals & Institutions Committee
Meets the 3rd Sunday of the Month at Unity Club in Redlands
1307 Brookside rd., Redlands CA92373
Contributions and Correspondence may be dropped off at Central Office in Colton or
mailed to
P.O. Box  3927
Riverside, CA 92519
Sign in to Google to save your progress. Learn more
Email *
Full Name (first and last)
Phone Number *
Sobriety date *
MM
/
DD
/
YYYY
Homegroup/City
Have you ever been or Are you currently involved with H&I service? *
If Yes, in what capacity were or are you of service?
Here are the various ways YOU can be of service with H&I. 
If you are interested in being on a panel? what type of facility do you prefer?
All panels that go into correctional Institutions require completion of application and Background clearance.
Keep in mind clearance levels vary at each facility as well as their requirements for application. Denial or acceptance in one facility does not apply to all facilities. We service Institutions in both San Bernardino and Riverside Counties. Each county has its own requirements. These clearances do take time to process but do not let that deter you from applying! If clearance is denied there are a vast amount of ways to take part in H&I with other panels that do not require so much red tape.

Lockdown Facilities need us now more than ever!
Do you have current clearance or simply need your clearance updated or renewed for any facilities? if yes, please detail clearance location and its current status
Would you like us to contact you and begin the Application and Clearance process in order to carry the message "behind the walls" as an H&I Panelist?
Clear selection
For Clearance please provide the following so we can easily copy and forward it to the designated County Deputy.  You will receive an Email from the Sheriffs Dept with the application and steps on how to proceed.

The County for clearance
Full Legal Name
Date of Birth
Phone #
Email
If you are seeking H&I services into a facility (info and literature), please provide the Name and Location of the facility/facilities. Please note H&I distributes Books to lockdown facilities only. However Additional literature and packets provided by our local Area 9 Treatment Committee are available to treatment centers or other places of recuperation that hold AA meetings listed with H&I
If Youre a facility seeking a panel visit, please provide your preferred general time and day(s) of availability for panel scheduling
Since Covid, H&I has the option of providing Virtual Panels into facilities if needed. What is your level of interest?
How familiar are you with Virtual Meetings?
Exploring the IE H&I interest in advancing communication technology. which methods utilized would best help increase interest in participation and communication
Please E-mail  AAintheIE@outlook.com with any further comment or Join us at our monthly Steering Committee meeting held on the 3rd Sunday of the Month At 3pm.
Meeting in Person only at 
Unity Club in Redlands
1307 Brookside, Redlands
909-307-4024

Please Note that This questionnaire is to get a feel for the needs in our Community. and as new developments arise , we will email updates!
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report