Class Registration
Email *
Name *
Email *
Address *
Phone number *
How long have you been released? *
Occupation? Or past occupation? *
What do you hope to get out of this course? *
Are you committed to completing the entire 12 weeks? *
Which location will you be attending? *
We can not offer transportation at the this.  Do you have reliable transportation to and from class? *

PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY AND INDICATE YOUR UNDERSTANDING AND ACCEPTANCE BY SIGNING YOUR NAME IN THE SPACE INDICATED.

*I certify that the statements made in this participant application are true and correct, and have been given voluntarily.

*I understand that this information may be disclosed to any party with legal and proper interest, and I release Prison to Purpose from any liability whatsoever for supplying such information.

*I agree that any written or oral misrepresentation in making this application is just cause for dismissal.

*I understand that participation in this program does not guarantee employment.

*I agree to adhere to the policies and procedures of the program.

*I understand that more than 3 absences terminate my participation in the program.

Do you agree with above statement *
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