Care Package Form
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The Youth Care Collective is an initiate through Circles & Ciphers. Circles & Ciphers is a hip hop infused Restorative Justice and Abolitionist organization located in Chicago. We are looking to support and give resources to people who are incarcerated in response to the COVID-19 pandemic. The Youth Care Collective is providing a one-time stipend of $100 to be added onto their account in order to support incarcerated youth. The Youth Care Collective is prioritizing Black people and People of Color. If they are selected to participate in the Youth Care Collective the incarcerated person will be sent $100 and a letter stating that you referred them to receive monetary support in their Inmate Trust Account. This program will run through December 31, 2021.

Our selection will be based on the following criteria:

Currently in Cook County Jail
12-29 Years Old
Needs monetary support with their Inmate Trust Account

*Please fill out one form for every incarcerated person you know that fits the criteria.*

Our services are free, and you and your loved ones identity WILL NOT be shared and will remain confidential. The information provided will be used to better understand and support the needs of the community.

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(Youth Care Collective es una iniciativa por el grupo Circles & Ciphers. Circles & Ciphers es una organización de hip hop infundido en la justicia restaurativa y abolicionista localizada en Chicago Il. Nuestro objetivo es a soportar y dar recursos a la gente quien a estado encarcelado en respuesta a la pandemia de COVID-19. Youth Care Collective esta dando un estipendio de $100 de una sola vez. Este estipendio sería sumado a su cuenta a fin de apoyo de los jóvenes encarcelados. Youth Care Collective esta priorizando la gente de raza negra y gente de color. Si está seleccionado a participar en Youth Care Collective, le van a mandar $100 y una letra diciendo que fueron referidos a recibir apoyo monetario en su cuenta a la persona encarcelada.

Tomaremos nuestra decisión en base a los siguientes criterios:

Actualmente en una cárcel de Cook County
Entre las edades de 12 y 29 años
Necesidad de apoyo monetario en su Inmate Trust Account*
*la cuenta de dinero del encarcelado

*Por favor de llenar una forma para cada persona encarcelada que conoces que ajuste estos criterios.*

Nuestros servicios son gratis y la identidad de usted y sus queridos no será compartida y quedaría confidencial. La información que usted provista estará usada para mejor entender y soportar las necesidades de la comunidad. )
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Your First Name (Tu Nombre) *
Your Last Name (Tu Apellido) *
Your Email or Phone Number (Tu Correo Electrónico o Número de Teléfono) *
Best Time/Day to Contact You (El mejor tiempo para contactarlo)
Please provide the Booking Number or Full Name of the Incarcerated Youth (Por favor proporcione el Booking Number o nombre completo del joven encarcelado) *
Their Preferred Language (Su idioma preferido) *
Their Race/ Ethnicity *
What is your relationship to them? (Que es su relación a la persona encarcelada?) *
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