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Correctional Facilities Sign-up Sheet

Correctional Facilities Sign-up

Sheet

for members willing

to Serve on the District Correctional Facilities Committee

If you are willing to be a member of the Correctional Facilities committee,

give your name, telephone number, sobriety date, email address and your

district. Your local Correctional Facilities contact person will contact you

for more details.

   
Name:

Phone Number:

Sobriety Date:

Email Address:

District: