Name*
First Last
Email*
Phone*
School*
Address*
Street Address City State ZIP Code
Grade*
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Donovan Prison Holiday Registration

Richard J. Donovan has partnered with Star/Pal to make December 25th a special visit with your family member for the holidays. Once you secure a visit with R. J. Donovan, please register your children below. Your family will be entered to receive a surprise during your visit.

"*" indicates required fields

Parent/Guardian Name*

First Last

Parent/Guardian Email Address*

Parent/Guardian Phone Number*

Child's Name*

First Last

Child's Gender*

Male

Female

Transgender

Non-binary/non-conforming

Prefer not to respond

Child's Age*

Are there any other children living at home?*

Yes

No

If yes, our Director of Operations, Mayra Nunez, will reach out to you for more information.

Inmate Name*

First Last

Inmate CDCR #*

Time Slot of your Visitation*

Please put start to end time.

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I am the…(Required)

Student

Parent/Guardian

Student Name(Required)

First Last

Program Interest(Required)

WE CAN (6th-8th grades)

TUTORING (Middle & High School)

MAKING CHANGES (High School)

Student Email Address(Required)

Student Phone Number(Required)

School Name(Required)

Grade Level(Required)

Parent/Guardian Name(Required)

First Last

Parent/Guardian Email Address(Required)

Parent/Guardian Phone Number(Required)

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Request a Speaker

"*" indicates required fields

Name*

First Last

Email*

Phone*

School Details

School*

Grade*

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Elevate

"*" indicates required fields

Name*

First Last

Email*

Phone*

Address*

Street Address City State ZIP Code

School Details

School*

Grade*

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LET’S BE PALS

"*" indicates required fields

Name*

First Last

Email*

Phone*

Address*

Street Address City State ZIP Code

School Information

School*

Grade*

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STORY TIME WITH AN OFFICER

"*" indicates required fields

Contact Information

Name*

First Last

Email*

Phone*

School Information

School*

School's Address*

Affiliation to School*

Classroom Grade Level*

# of Students in Class*

Type of Class*

Please give us a little more information about your class and if it’s special day, bilingual, after-school, etc.

How would you like our officer to join your classroom?*

Virtual Platform

Please let us know what virtual platform you are currently using for your class if the request is to join virtually.

Virtual Login Info

Please let us know the Meeting ID and Password if request is to join virtually.

Availability

Please list your top 3 available days in order of preference.

First Choice*

Second Choice*

Third Choice*

Time Availability*

Please provide us some info on the best time for an officer to join your class for Storytime and we will do our best to work with your class schedule.

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Friday Availability*

1st Choice

2nd Choice

3rd Choice

Please list your top 3 available Fridays in order of preference.

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Classroom Grade Level*

[ctct form=”47″ show_title=”false”]

Brad Wiggins – Edited

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