MAILING ADDRESS:
Name_________________________________________________


Nickname______________________________________________


DOC #_________________________________________________


Cell Location
(if applicable)__________________________________


Facility Name___________________________________________


Address_______________________________________________


City___________________________________________________


State________________________  Zip______________________
CHOOSE TYPE OF AD:
Subscription Length:

           _____  6 months + 3 months free!!!!

           
_____  1 year + 3 months free!!!

           _____  2 years + 6 months free!!!

           _____  3 years + 1 year free!!!




Extras:
           _____ # of extra photos @ $2.50/photo


           _____# of extra words @ 1-50 words, $2.00
                                                           51-100 words, $3.50
                                                           101-200 words, $6.00

Enclose completed application, photos, SASE (if you want photos returned, )written
message (see below) and payment in the form of personal check, money order, bank
check or stamps to correct address.  For address see home page or click
here.
DESCRITPTION:
Offenses______________________________________________


   ______________________________________________


   ______________________________________________


Date Incarcerated______________________________________


Next Parole Date_______________________________________


Latest Release Date____________________________________


On Death Row?     
Yes___________         No_____________
OTHER  PERSONAL INFORMATION:
Interests & Hobbies___________________________________


   _____________________________________________


   _____________________________________________


Pet Peeves___________________________________________


   _____________________________________________



Sexual Orientation:    
Straight___________        Gay___________


Bi-sexual_________   Transgendered_________   Transvestite___________



Whom Do You Seek To Write?:     

   Men_______                 Women_______                Both_________



What Do You Seek?:        Friendship________    Romance_________


                                                 Legal Help________    Donations_________


Are You Willing To Write To People Overseas?
                                    
(postage will cost more)


           Yes________                                        No________
D.O.B.____________________________


Height______________________  Weight___________________


Eye Color_________________   Hair Color__________________


Race_________________________________________________


Religion______________________________________________


Zodiac Sign___________________________________________


Education_____________________________________________


Marital Status__________________________________________


# of Kids___________________
OFFENDER INFORMATION:
On a separate piece of paper write a message - up to 300 words - for
your ad.  Write about yourself, what you are looking for, your goals
and dreams and anything else you like to say to your potential pen
pals.