SOP_NUMBER: 503.01-att-1
TITLE: Faith and Character-Based Dormitory - Offender Application
REFERENCE_CODE: VK01-0001
DIVISION: Unknown
TOPIC_AREA: 503.01 Policy - Facilities
EFFECTIVE_DATE: 2025-08-07
WORD_COUNT: 127
POWERDMS_URL: https://public.powerdms.com/GADOC/documents/106511
URL: https://gps.press/sop-data/503.01-att-1/

SUMMARY:
This is an application form for inmates who wish to participate in the Faith and Character-Based Dormitory (FCBD) program. The form collects demographic information, housing history, disciplinary record, educational background, program participation history, and the applicant's motivation for joining the program. Eligible inmates submit this application to be considered for placement in this specialized housing unit.

KEY_TOPICS: faith-based housing, character-based dormitory, FCBD, inmate application, housing placement, program participation, religious affiliation, disciplinary record, inmate programs, residential unit assignment

ATTACHMENTS:
  1. Faith and Character-Based Dormitory - Offender Application
     URL: https://gps.press/sop-data/503.01-att-1/
  2. Faith and Character Dormitory Offender Contract
     URL: https://gps.press/sop-data/503.01-att-2/
  3. Faith and Character-Based Dormitory Rules
     URL: https://gps.press/sop-data/503.01-att-3/
  4. Faith and Character-Based Program - Correctional Associate (Volunteer) Contract
     URL: https://gps.press/sop-data/503.01-att-4/
  5. Faith and Character-Based Prison Application
     URL: https://gps.press/sop-data/503.01-att-5/

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FULL TEXT:
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**503.01**
**Attachment 1**

**08/07/25**
**Faith and Character-Based Dormitory**

**Offender Application**


**LAST NAME** : ____________________________ **FIRST** :________________

**GDC NUMBER** : _____________________ **DOB** : ______________

**CURRENT HOUSING UNIT** : ____________ **CURRENT DETAIL** : __________

**LAST DISCIPLINARY REPORT** : ____/____/____

**PRIMARY LANGUAGE: __________** **HEARING/VISUALLY IMPAIRED:** YES NO

|RACE: (CIRCLE ONE)|Col2|Col3|Col4|
|---|---|---|---|
|ASIAN|AFRICAN AMERICAN|NATIVE AMERICAN|MULTIRACIAL|
|PACIFIC ISLANDER|HISPANIC/LATINO|WHITE|OTHER|



**US CITIZEN** : **(CIRCLE ONE)** YES / NO **ICE/INS DETAINER** : YES / NO

**RELIGIOUS AFFILIATION: _____________________________**

**HIGHEST EDUCATIONAL LEVEL COMPLETED** : ____________________________

**TPM** : ____/____/____ **MRD** : ____/____/____

**DO YOU HAVE ANY MEDICAL PROFILES?** YES  NO  IF SO, WHAT?
_______________________________________________________________________

**PROGRAMS COMPLETED:** **(CIRCLE PROGRAMS TAKEN)**

MOTIVATION FOR CHANGE PARENTING MRT PSSIA

MATRIX THINKING FOR A CHANGE CONFRONTING SELF SOPP

REENTRY SKILL BUILDING GED BEHAVIOR STABILIZATION

ABE FAMILY VIOLENCE ITC FCBD

**VOCATIONAL___________**

**OJT__________________**

**WHY DO YOU WANT TO PARTICIPATE IN THE PROGRAM?**
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________


**DO NOT WRITE BELOW THIS LINE**