2023 Reentry Conference & Resource Fair Registration

Free Admission, Continental Breakfast, Lunch and Parking

First Name: *

Last Name: *

Contact Phone Number: *

Email contact: *

Please confirm your email *

Website (if you have one):

Is this your first time attending the Reentry Conference, Resource and Job Fair? *

Yes

No

I learned about this event through? *

I'm attending the Conference and Resource and Job Fair as a: *

1 - Attendee only

1.2 Webinar Attendee

2 - Assisting in an organization (Non-profit, Government Agency, or Project) that ALREADY RESERVED A TABLE.

3 - Speaker: Panel Moderator or Presenter (invited by the Restorative Justice Ministry)

4 - Hosting a table for a Non-profit, Government Agency, or Project (CLICK THIS OPTION TO RESERVE A TABLE)

5 - Crime Survivor (reserving a table for a Shrine of Remembrance)

6 - Volunteer (to help support this event) *

Please share which sessions you might attend. *

Please select which webinar sessions you will attend. *

8:30 A.M. - Welcoming Remarks / Keynote / CALIFORNIA HOUSING NEEDS OF JUSTICE-INVOLVED

10:30 A.M. - FAITH AFTER INCARCERATION

* Volunteer opportunities include outreach, setting up, registration, assisting during the event in various capacities and cleaning up. *

Volunteer outreach before the event (before the event).

Volunteer the day before the event (1:00 p.m. to 4:00 p.m.)

Volunteer during the event (7:00 a.m. until 3:00 p.m.)

Volunteer to clean up after the event same day (3:00 p.m. to 5:00 p.m.)

Please specify the name of Non-profit, Government Agency, Project, Business / Company. (This option is ONLY for adding individuals for an Organization, Government Agency or Project that ALREADY reserved a table. *

Please specify the name of the panel that you are moderating or presenting on, approved by Julio Escobar. *

We ask that all speakers participating in panel discussions dress professionally. Do you accept? *

Yes.

Volunteer Comments (optional):

Non-profit, Government Agency, Project

Non-profit Organization or Government Agency name *

Contact's name (Responsible for exhibitor's table) *

Contact Phone Number *

Your Title or Position *

Website link: *

Street Address *

City *

State *

Postal Code *

Will there be more than one person sitting at your exhibitor's table? *

Yes

No

(2nd Person) First and Last Name

(2) Email Address

(3rd Person) First and Last Name

(3) Email Address

(4th person) First and Last Name

(4th person) Email Address

(5th person) First and Last Name

(5th person) Email Address

*Note: Alternate persons in an exhibitor's table must register separately as an attendee.

Please choose categories of services your organization provides: *

Does your client need to be on probation? *

Yes

No

Does your client need to be on parole? *

Yes

No

Age range of your target population (men and women): *

Youth (ages 18-24)

Seniors (age 55+)

All ages

Special populations to qualify for support: *

Description of services or products you offer to formerly incarcerated individuals to support their post release needs:

Description of services or products you offer to crime survivors to support their healing:

I identify myself as: *

A formerly incarcerated person

A family member with a loved one incarcerated

A crime survivor

None of the above

Advocacy	Employment Services	Education Services
Housing Services	Health and Treatment Services	Legal Services
Faith Based Organization	Family and Children	Other Other