Resilient Children of Incarcerated Parents
This form is used to gather information in scheduling your possible interview on your successes. If you have any questions or concerns email Dr. Bahiyyah Muhammad at coipstudies@gmail.com.
Email address *
Name (First and Last)
Preferred Pronouns
Clear selection
Phone Number
Current Place of Residence (City and State) *
Are 18 years old or older? *
Which parent was/is incarcerated? *
Required
How long was or has your MOTHER been incarcerated, if applicable? *
How long was or has your FATHER been incarcerated, if applicable? *
How were/are you in contact with your MOTHER during incarceration? *
Required
How were/are you in contact with your FATHER during incarceration? *
Required
Which of these areas do you believe you have you been successful in? *
Required
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