Kairos Team Application

 

Team Application – Bartlett Kairos #26

Please use the information as it appears on your Driver’s License

Prefix                First Name     MI               Last Name                                Suffix

      

Address

 

 

City                                                         State                      Zip

         

Address that Inmates will use to mail letters to you (not your home address):

City                                                                                          Zip

                                     

Daytime Phone           Home Phone               Cell

    

Email   

Date of Birth           DL Number              SS Number                   TDCJ Trained?

                     

Are you related to or know anyone in Bartlett Jail (other than through Kairos)?  Yes___No___

Are you on a visitation list at Bartlett State Jail?  Yes ___No___

If  “Yes”, Inmate’s Name 

Inmate’s TDCJ Number

Your name as you sign it agreeing that all the above is true

Date 

Your Church

Church Address State   Zip 

Pastor’s Name   Church phone

Print and Send Team Application to:
Garry Sjolander
1216 Amistad Dr, Round Rock, TX 78660