Faces of Women Imprisoned Application

Faces of Women Imprisoned Fast Track Application

Faces Of Women Imprisoned is a powerful opportunity for the public to hear and learn from Incarcerated women through public symposiums. Equally important, it provides a training ground for incarcerated and formerly incarcerated women who never had the encouragement and the opportunity to publicly speak about their experiences and how what they learned can inform and transform public policy and legislation. Faces Fast Track is a speakers' intensive course that focuses on sharpening your public speaking skills. Faces Of Women Imprisoned has developed a speaker bureau, the first of its kind created and run by impacted women. The speakers bureau will deepen and broaden the public conversation, empower formerly incarcerated and impacted women and provide income for women as they speak around the country.
What is your Full Name *

First Name Middle Name Last Name
What is your date of birth? *

Month Day Year
Date
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Please list your Primary Phone Number *

Area Code Phone Number
Email Address *
What gender do you identify as? *

Female Male Prefer not to say Other
How would you best describe yourself? *

Native American Asian Black Pacific Islander White Multi-racial Hispanic/Latinx Other
Other Gender Identity
Please list your Social Media Handle(s) *
Facebook, Instagram, Twitter
How many children under the age of 18 live in your household? *

None One Two Three Four Five More than five
Current Income Range *

Unemployed $25,000 or less $25,000-$50,000 $50,000-$75,000 $75,000 or more
Have you or a Family Member been impacted by incarceration? Please select all that apply *

Myself Spouse Parent Sibling None Other
Please describe Other Family Member
What topics do you advocate for? Please select all that apply *

Women's Rights Education Justice Reform Housing/Homelessness Parole & Probation Employment Entrepreneurship Healthcare Gender Equality Racial Equality Addiction Spiritual Empowerment Other
Please describe Other topics
Do you have experience speaking publicly? *

Yes No
Education Background
Would you be able to commit to the 6 month long program requirements?

Yes No
What do you wish to gain from this experience?
What are your long term career goals?
How did you hear about this program? *

The LOHM Website A LOHM employee Social Media
Signature *

Clear
Program SFID
Salesforce Cohort
For questions please contact Patricia Lewis - plewis@thelohm.org
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