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Inmate's first name

Inmate's last name

Department of corrections number

Inmate's address

Country

First name

Address 1

Address 2

City

State

ZIP code

Date inmate is expected to be released

Your first name

Your last name

Your e-mail

Your phone number

Your fax number

Your address

Country

Address 1

Address 2

City

State

ZIP code

Your profession

Age

Type of story

Have you/will you meet this inmate in person

Length of time you have been corresponding

Photo description

Please tell us a little about your story