Leon County Sheriff's Office > ALLin LEON > Re-Entry Programs > Inmate Programs

Inmate Program Application
If you have a program you would like for our re-entry team to present to our inmate population, fill out the form below to submit an application for consideration.
INMATE PROGRAM APPLICATION
APPLICANT CONTACT INFORMATION
Applicant Name
Street Address
Mailing Address (if different)
Phone Number
Email
PROGRAM INFORMATION
Title of Program/Service:
Intent of Programs/Service:
Duration of Program/Service:
Number of participants in class:
Are there any potential copyright violations associated with the program being applied?
Are you receiving grant funding for implementation?
If selected YES to the previous question, please provide grant title and agency.
Have you already been in contact with a representative from LCSO regarding this program?
If selected YES to the previous question, please provide the name and title of the program.
SUMMARY OF PROGRAM
Please provide a response to the following questions regarding the program/service being applied for.
1. Is there structured curriculum, lesson plan, facilitator’s guide, or outline that shows the overall objective of the program and the modules or topics covered in each session? If yes, please briefly describe and attach all applicable material.
2. Will any modifications be made to this program? (e.g. shortened, changed topics/activities, or changed in any way). If yes, please explain.
3. What is the total number of program hours? Include number of days per week and number of hours per day.
4. What is the minimum and maximum number of participants in a group/class?
5. Who is your target audience/participants? Are there any exclusions or specific inclusion criteria?
6. Will you be providing the staff to deliver the program? If NO, please describe who will facilitate the program/service.
7. Is training and/or credentialing required to facilitate the program? Please detail training requirements and/or possible credentials.
8. What teaching method(s) will be used to deliver the program?
9. How will you monitor the outcomes and/or completion of the program/service? (e.g. surveys, pre/post test, and/or interviews).
10. Please list any other states or agencies that are currently (or previously) using this program/service?
11. Describe any benefits to the participant, community and/or the Leon County Sheriff’s Office.
12. Is there a cost related to this program/service? If so, please explain in detail
13. Is there any other pertinent information you wish to provide?
SUBMISSION OF APPLICATION AND MATERIALS
Check any of the boxes below to indicate what materials are being submitted.

Applications will only be reviewed once all applicable material is received. Please ensure all supporting documentation and materials are included with the submission.

DOCUMENTATION/MATERIALS

Complete Application

Curriculum or Lesson Plans

Facilitator's Guide

Pre-test and/or Post Test

Credentials, license or training documents for facilitator

Participant manual/guide

Other Program Materials

If OTHER, please specify:
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Inmate Program Application

INMATE PROGRAM APPLICATION

APPLICANT CONTACT INFORMATION

PROGRAM INFORMATION

SUMMARY OF PROGRAM

SUBMISSION OF APPLICATION AND MATERIALS

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