"*" indicates required fields NameThis field is for validation purposes and should be left unchanged.What is your full name? First & Last name.* First Last What is you phone number?*Example : (123) 456-7810. Generally, a number that should be able to receive contact from a member of the committee.What is your email address?* Address City State / Province / Region ZIP / Postal Code Please fill in your City, State & Zip Code only.Sobriety Date MM slash DD slash YYYY What is your AA anniversary date?I would like to participate in the following facilities:New Committee MemberNew Volunteer for DOC MeetingsNew Volunteer for Local Jail MeetingsContact Method Direct Phone Call E-Mail Text (SMS) Message You will be contacted by an Area Corrections Volunteer or Facility Liaison what is your preferred contact method?Previous corrections experience ...YesNoPlease tell us if you have had any previous corrections experience, if any.
