FISS Application

FISS Application

If you are a formerly incarcerated person and would like to present at the Formerly Incarcerated Speaker Series, please fill out the form below. Keep in mind that: WE HOLD SELF AND SYSTEM ACCOUNTABLE! For legal reasons: WE DO NOT OPENLY DISCUSS ANYTHING WE HAVE NOT SERVED TIME FOR.
My name is   first name*   last name *
I was incarcerated for   number*      years.
While incarcerated I was employed as a job title . *
And, I paroled on    date*
What prison did you parole from?
What prison did you parole from?
Short bio for speaker
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Please provide a clear and concise description of the subject you would like to talk about. Feel free to use bullet points or an organized brain dump. Subjects can include: Your story of transformation. A prison experience that informs audiences what it's like to be incarcerated (i.e. being denied access your family, parents, siblings, spouse, and/or children). Laws and policies whether old or current that affect youth in our community. 250 words max.

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E-mail

Confirmation Email
Phone Number
Format: (000) 000-0000.
State
City
What city do you live in?
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Pick the date you would like to speak from the drop down lists below. List the days in order of preference and availability.