----INMATE APPLICATION---- ----Print This---- First Name: Last Name: DOC# Cell: Address: City: State: ZIP Code: Your Sex (circle): male or female Date of Birth: month/day/year Race: (circle) African American Asian Caucasion Hispanic Native American Other: Release Date (optional): Religion (optional): >>>For the written (poems, personal, etc) portion of your ad, use additional pages as necessary. Come on this is your time to shine! Say anything you want! Count your words. ---------------------------------------------------------------------------------------- Select and circle your ad: >>> HOT ($19.00/yr.) 200 words & 1 photo >>> REAL HOT ($29.00/yr.) 300 words & 2 photos >>> MAJOR HOT ($39.00/yr.) 400 words & 3 photos Method of payment and amount enclosed (Circle One): >>> Institution Check Personal Check Money Order ------------------------------------------------------------------------------------------ ******Please make Check or Money Order payable to: hotprisonpals.com PLEASE MAIL ALL INFORMATION FOR YOUR WEB PAGE TO: ****************************** Hot Prison Pals.Com 373 Broadway Suite C-2 New York, N.Y. 10013 ****************************** Your ad will be up as soon as possible, but remember to include a Self addressed, stamped envelope (with enough stamps) if you want your photos or ad back. We will not return any ads or photos to you with our own stamps.