Nolef Turns · Nolef Turns Pre-Release Intake Application

Please read this first before submitting this application.*

This application is for individuals who are currently incarcerated in a Virginia Department of Corrections or Federal Bureau of Prisons facility (or someone completing on behalf of an individual who is incarcerated) and will be released within the 6-12 months.

If you have been released from a Virginia Department of Corrections or Federal Bureau of Prisons facility in the last year, please complete the Re-Entry intake application.

If you have been convicted of a felony conviction in the state of Virginia within the last year, please complete the Re-Entry intake application.

If you only need assistance with voter registration, restoration of rights, or miscellaneous services, please complete the Special Programs application.

For referrals, please complete a Community Partner application prior to submitting your first referral application.

I accept the Terms and Conditions. *

Yes

Name *

Prefix

First Name

Last Name

Suffix

Race/Ethnicity *

White or Caucasian

Black or African-American

Asian

American Indian, Alaska Native, Native Hawaiian or other Pacific Islander

Multi-Ethnic

Other

Gender *

Female

Male

Non-binary/Non-conforming

Other

Phone *

Email

Please provide an email for professional contacts.

Verify Email

Date of Birth *

(mm/dd/yyyy)

Social Security Number *

###-##-####

Current Location *

Please choose the facility which you are currently housed at

Inmate Identification Number *

Current Virginia Department of Corrections Facility Mailing Address *

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Referred by *

Please list your felony conviction(s), date of conviction and court *

Please accurately list all city, county, and/or federal court(s) of conviction, along with all felony charges. If you do not list all convictions, services cannot be provided.

Expected Release Date *

Please list your expected release date.

Does your expected release date include good time credit calculations? *

Yes

No

Do you have any family/community support? *

Yes

No

What is your highest level of education? *

Programs/Certifications *

Please list work experience, institutional programs completed and/or skills. Include apprenticeships, trade certifications and volunteer work.

Please briefly list the service(s) you need assistance with. Please note that all information shared with our organization is in complete confidentiality and the information obtained will be used to assist in your success. *

Please be specific.

Please list other service providers you have explored or are receiving services from, if applicable.

(CSB, CPS, Stabilization, Judiciary, DSS or other mental health (please list names and contact information))

Signature (TYPE YOUR FULL NAME) *

By signing this form, you give permission to communicate with others on your behalf regarding the services requested. You acknowledge that Nolef Turns does not offer legal advice and we cannot guarantee results for each participant.

Please send completed application, consent forms and a copy of your resume (if available) to:

Nolef Turns Inc.

Attn: Client Intake Application

3002 Hungary Spring Rd.

Ste. 102

Henrico, VA 23228-2425

Online at www.nolefturns.org

or email to:

admin@nolefturns.org