CCV Application

If you are a licensed and ordained minister within your community, we would love for you to receive Clergy Contact Visiting credentials in order to visit with members of your community. You can begin this process by filling out and submitting the form below. 

 

clergy contact visiting application

APPLICANT
Name *
Name
What is your D.O.B.? *
What is your D.O.B.?
Are you male or female? *
What is your address? *
What is your address?
What is your primary phone number? *
What is your primary phone number?
What is another number where you can be reached?
What is another number where you can be reached?
CHURCH/CONGREGATION
What is the address of your church/congregation? *
What is the address of your church/congregation?
What is the phone number for your church/congregation? *
What is the phone number for your church/congregation?
ACCOUNTABILITY
Provide the following information for a person in leadership within the church, congregation or organization you are currently serving and to whom you are accountable. Do not put your own name. *
Provide the following information for a person in leadership within the church, congregation or organization you are currently serving and to whom you are accountable. Do not put your own name.
What is this his/her address? *
What is this his/her address?
What is his/her phone number? *
What is his/her phone number?
AGREEMENT
In applying for the Transforming Jail Ministries Clergy Contact Visiting Program, I authorize the release of any records/information necessary to support/refute any item in this application for contact visiting. I further agree to release from all liability any person(s) or institution(s) supplying any of the information requested by the Sheriff of Hamilton County, Ohio or designated representatives. *
In applying for the Transforming Jail Ministries Clergy Contact Visiting Program, I authorize the release of any records/information necessary to support/refute any item in this application for contact visiting. I further agree to release from all liability any person(s) or institution(s) supplying any of the information requested by the Sheriff of Hamilton County, Ohio or designated representatives.
Date of application. *
Date of application.
By submitting this Clergy Contact Visiting application, you give Transforming Jail Ministries permission to send you information about TJM and the Clergy Contact Visiting program. We will not give or sell your information to others.