Prison Ministry Volunteer Activity Report Volunteer InformationVolunteer name(Required) First Last E-mail(Required)A confirmation e-mail will be sent to the e-mail provided. Enter e-mail Confirm e-mail Phone(Required)Method of contact preference(Required) E-mail Phone Member church name(Required)City(Required)State/Province(Required)Select one . . .AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonVisit InformationDate of visit(Required) MM slash DD slash YYYY Select a facility(Required)Select a State/Province first. After each selection, the next drop down field will pre-populate with options to select. If the facility is NOT listed, select the checkbox in the next field for Other facility. State/ProvinceAKALARAZBC/CanadaCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY Facility City Facility Name Facility Address Other facility The facility I visited is NOT listed in the above drop down options Enter new facility name, city, and state/province(Required)Type of visit(s)(Required) Baptism Lord's Supper Bible study Mentoring for release Counseling/Encouragement Other If other, enter type of visit(Required)How was the visit conducted?(Required) In-person Via a video link Estimate count of attendees(Required)CommentsComments for volunteer notesComments for inmate questionsData Privacy & Permission(Required) I AGREE with the terms of the WELS Privacy Policy.NOTE TO EU CITIZENS, RESIDENTS, TOURISTS, AND OTHER PERSONS TEMPORARILY IN THE EU: By submitting this form you consent to any and all information you provide and submit via the site being sent to the United States of America. The United States has not sought nor received a finding of “adequacy” from the European Union under Article 45 of the GDPR. WELS relies on derogations for specific situations as set forth in Article 49 of the GDPR. You are also informed that the United States presently does not have an adequate level of personal data protection as determined by the European Commission’s adequacy decision on October 6, 2015 (case c-362/14) and articulated in the European Union’s General Data Protection Regulation and has not received a similar designation of adequacy by any other foreign data protection authority. You agree to the transfer of your data and personal data to the United States, however, to be used in accordance with WELS Privacy Policy.CAPTCHA Δ Prison Ministry: [email protected]Ref: Prison Ministry Volunteer Activity Report
