- Matthew 25:40
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The Matthew 25 Center Burgaw, North Carolina
Matthew 25 Center
Housing Application
"A home away from home for families who visit their loved ones in prison."
Applicant Name (First Name, Last Name):
Street Address:
City, State & Zip Code:
Home Phone (area code and number):
Work Phone (area code and number):
Cell Phone (area code and number):
E-Mail Address:
Name of inmate you will be visiting:
Inmate's OPUS Number:
Your relationship to the inmate:
List of all guests who will be traveling with you and their relationship:
Are you on the inmates approved visitation list?
Are all persons traveling with you on the inmate's approved visitation list?
Do you have an appointment to visit this inmate?
If so, what is the date of your appointment?
How many miles do you have to travel from your home to visit this inmate?
How will you travel?
When do you want to stay at The Matthew 25 Center?
What will be your estimated time of arrival?
Have you used The Matthew 25 Center before?
Do you have special needs that we need to know about?
If yes, please explain:
I have read and agree to abide by the House Rules. Yes
I declare that all the information given on this form is correct.
Name:
Date:
Important Note: Before contacting The Matthew 25 Center you must contact the jail or prison and set up your visit. Then fill out the entire application. The Matthew 25 Center cannot accept reservations for persons who do not have visitation appointments with the prison. When we receive your application, we will call you and confirm your reservation at The Matthew 25 Center.
Submit the Form: