PLSE Do it Yourself Expungement Clinic Registration Form
Date of Birth
Mailing Address (include Apartment Number, City and Zip Code)
Which of the following Clinic dates are you able to attend? (Choose all that apply)
Thursday, August 2nd: 6pm - 8pm at the People's Emergency Center, 3939 Warren St. (W. Philly)
Thursday, August 23rd: 6pm - 8pm at the People's Emergency Center, 3939 Warren St. (W. Philly)
How did you hear about our expungement clinics?
Friend or Family
People's Emergency Center
Would you like to be added to PLSE's email list to learn about additional events?
*Clinic slots will be filled on a first-come first-served basis. After registering you will be informed by phone or email regarding your registration status. Please be aware there may not be enough slots for each person who completes this form.*
Due to the limited amount of space, please notify us if you are no longer able to attend
(267) 519-5323 or
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This form was created inside of Criminal Record Expungement Project (C-REP).