Use this form if you have the inmate's profile ready and you want to get them listed on this site now. You have up to 12 months to make payment for the profile after submitting the form.
*INMATE FIRST NAME:
*INMATE LAST NAME:
*INMATE ID NUMBER:
*INMATE ADDRESS:
INMATE DATE OF BIRTH: Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900
HEADING:
INMATE GENDER: Male Female
INCARCERATED SINCE:
RELEASE DATE:
CONVICTED OF:
HOMETOWN:
RACE/ETHNICITY: Select AfricanAmerican Asian Caucasian Hispanic NativeAmerican Islander MultiRacial Other N/A
RELIGION: Select Agnostic Atheist Baptist Buddhist Catholic Christian Jewish Mormon Muslim NonDenominational Pagan Spiritual Wiccan Other None N/A
HEIGHT:
WEIGHT:
WANTS TO WRITE TO: Women Only Men Only Anyone
SEXUAL ORIENTATION: Straight Gay Bisexual
OPEN TO GAY BISEXUAL CONTACT (OF INMATE'S OWN GENDER): Yes No
WILL WRITE OVERSEAS: Yes No
SEEKING (check all that apply): Romance Friendship Legal Help Donations Other:
IS THE INMATE (check all that apply): A Lifer On Death Row Gay/Bisexual
MAIL PREFERENCE: Write directly, no emails Write directly AND emails
WEBPAGE: Basic Basic w/Brochure (includes the brochure, "How To Write A Better Pen-Pal Ad", with sample ads) Deluxe Deluxe w/Brochure (includes the brochure, "How To Write A Better Pen-Pal Ad", with sample ads)
WEBPAGE RENEWAL (check if applies): Webpage Renewal
WEBPAGE TYPE: Personal Legal Art/Business
REFERRED BY:
IMAGES (PHOTOS, ARTWORK, AND DOCUMENTS): Only *.gif, *.bmp, *.png, *.jpg, *.jpeg files allowed.
STATEMENT (BIO):
*YOUR NAME:
*YOUR EMAIL ADDRESS:
COMMENTS:
*PAYMENT METHOD: Select Paypal Paypal - send me an invoice! Credit or debit card Check or money order Money or wire transfer Institution check (from inmate's account)
*AGREEMENT:
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