JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Jail/Prison Ministry Report
This report is to be submitted after each Jail/Prison Ministry Visitation. Please be quick to make remarks about your visit. Any information not included within the questions below should be included in your remarks.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Facility
*
Choose
ASMP
Burruss CTC
Central SP
Dooly SP
GDCP
Hancock SP
Hays SP
Lee SP
Macon SP
McEver PDC
Metro Reentry
Patton PTC
Perry PDC
Phillips SP
Rogers SP
Rutledge SP
Smith SP
Telfair SP
Terrell RYDC
Valdosta SP
Ware RYDC
Ware SP
Other - Use Remarks Section
Date of Visit
*
mm/dd/yyyy
MM
/
DD
/
YYYY
Member Name
*
Your answer
# of Gideons
*
Choose
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Other- Enter Correct # in Remarks section.
Bibles Dist
*
Choose
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
Unknown
Other- Enter Correct # in Remarks section.
Length
*
Choose
0
30
60
90
120
150
180
210
240
270
300
Other- Enter Correct # in Remarks section.
Sinner's Prayer?
*
Choose
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Other- Enter Correct # in Remarks section.
Remarks/Comments
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report