PEN-PAL APPLICATION 
 
The information on this application will be used to post your request to the internet.
Your application will be sent to several international pen-pal INTERNET web-sites.

REMEMBER : ANYONE WITH AN INTERNET COMPUTER - WILL BE ABLE TO SEE THIS INFORMATION !
DO NOT include any information that you do not want the entire world to see !

You DO WANT people to write you --- say things that will be interesting to them.

Name: Mr/Mrs________________________________________  Nationality:__________________

Name of Prison:_______________________________________   Building number:___________

Age:_____: (Birthday)?_____-____-____ :  Hometown:__________________________________

Put your photo on the internet ?: Yes / No:     Religion:___________________________

Family : Parents:___________________________________________________________________

Family : Brother/sister/wife/children:______________________________________________

Charges:( describe briefly ):_______________________________________________________

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Sentence years:__________      Number of Years already served:___________

Your interests/activities BEFORE coming to this prison:_____________________________

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Your interests/activities AFTER coming to prison:___________________________________

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Your plans for your future:_________________________________________________________

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Preferred age of your pen-pal (circle your choice) : minimum / maximum / any 

Preferred sex of your pen-pal (circle your choice) : male    / female  / any

Prepaid-Postal return-coupons (circle your choice) : none    / please  / REQUIRED

PLEASE LIST ME ON THESE WEB-SITES : ( please put a "x" for your choices ) 
phaseloop.com _____ : Fallen Angels____ : Jens.blechert____  : CellPals.com____  
alex-gibson.com____ : Bangkwang.Net__X_ : Irene's List ____

Sign and date your application here:_______________________________ date: __________