Please be sure to send this application in it's entirety. Thank you.

PLEASE PRINT NEATLY (OR TYPE) PRISONER'S INFORMATION

Title: (Please circle one.) Mr.  | Mrs. | Ms.  |
Last Name:___________________________________________
First Name:___________________________________________
Department of Corrections Number:________________________
Name of correctional facility:______________________________
Street Address:________________________________________
____________________________________________________
City:______________State:___________Zip Code:____________
Sex: Male   | Female  | Transgender
Race: African American  |Caucasian | Hispanic  | Native American  | other:
__________________________________________________
Religion: (Please circle one) Agnostic | Atheist  | Catholic | Hindu | Jewish  | Muslim  | Protestant  | other:
__________________________________________________
Release or next available parole date:______________________
Date Of Birth:________________________________________
Age:_______________________________________________

Sexual Orientation (Please circle one): Bisexual | Straight  | Gay  | Lesbian

Optional
Is prisoner on Death Row? yes | no
Is prisoner serving a life sentence? yes | no
Is prisoner seeking donations? yes | no
Is prisoner enclosing original poetry in your ad? yes | no
Is prisoner enclosing original art work to the ad? yes | no
 

General Information

1. Anyone who places a false photo will be removed from the site.
2.. Address changes are FREE!
3. CellPals! does not charge it’s visitors for a prisoner's address. Addresses are posted on our website and is given freely to all that view a prisoner's page.

Price List - Please check all that apply to your order

❐300 word annual ad with one photo OR one original piece of artwork: $11.95
❐ 300 additional words: $7.99
❐ 1 additional photo/artwork: $2.99
❐ Renewal of ad (changes to biography can be made, when renewing for no additional fee): $9.99
❐ Ad change: $5.99 (to change the wording of your biography)
❐ Additional ad printouts: $2.99 each
❐ Photo/Art Gallery: $2.99 for each placement
❐ Extra States/Countries: $1.00 each (Don’t include your state of incarceration - that’s free!)
❐ Counter - this gives you a count of how many people have viewed your ad! : $3.99
❐ Add A Tune: $5.99    ❐Music only    or Music Video  ❐ $7.99
❐ Copy of site: $2.99
❐ Request for Book/Magazine Donations: $5.00 , please limit requests to 20.
❐ Poems: $1.00 each
❐Glitter Graphics $9.99 each
❐Thumbnail Photo on state page by name: $2.99
❐ Search Engine Submission: $12.95 (Lists you on about hundreds of additional sites other than CellPals.com)
❐ Email Campaign: $7.95 (Your ad is delivered to the inbox of 100's of CellPals members who are on our mailing list!)
❐ Email Service: $29.95 for 6 months - $50.00 for 12 months
❐ One Week Photo Feature: $7.99 per week (Your name featured on the HOMEPAGE of CellPals.com, with a direct link to the prisoner's website for one week)
❐ **POWERBALL**: $19.95 (Your name featured on the HOMEPAGE of CellPals.com, with a direct link to the prisoner's website for one month)
❐ Copy Services: Photos**4x6, 5x7: $3.00 ea**8x10 $4.00 ea. Papers: $. 25 cents per side + postage to return or mail.  
❐Sports Logos:  $1.99 per logo
Name Accents: How the prisoner's name will appear on our listings!
❐ Bold: $1.50
❐ Enlarged: $1.50
❐ Italicized: $1.50
❐ Color $1.50 Pick one: Red ❐ Green ❐ Blue ❐ Purple ❐  etc...._______________
❐ Smiley Face Graphic: $2.00
❐ Heart Graphic: $2.00
❐ Arrow Graphic: $2.00
❐ Chick Flicks $1.50 per picture, whether singles or multiples on one page.

Packages: By checking the items above you may add additional items to your package in order to create a site, which best fits your needs.

❐ CellPals! Complete Package: $100.00
300 word biography, 2 year enrollment, PowerBall x2, 1 counter, 2 pictures, 1 photo or art gallery, 20 additional state/country placements, 1 copy of site,  Book/magazine Request Feature, Email Service (for six months), Email Campaign, thumbnail photo on state page, Glitter Graphics X 2, Add A Tune, Music Video, One photo copy, one sports logo or extra photo copy.  . Get maximum exposure with the Complete Package!

❐ CellPals! Power Plan Package: $50.00
300 word biography, 2 year enrollment, 1 PowerBall, 1 counter, 1 picture, 1 Gallery placement, 1 artwork or extra photo, 5 additional state/country placement, 1 copy of site, Email Campaign, Glitter Graphics X 1 and one photo copy of any size, one sports logo or extra photo copy.

❐CellPals! Intermediate Package : $19.95
Includes: 1 Year Registration, 300 word biography, 1 picture or artwork, 1 copy of site, two weeks PowerBall

❐ CellPals! Starter Package: $11.95
300 word biography, 1 year registration, 1 picture or artwork, 1 copy of site, "thumbnail photo" on state page, by name.

❐ Five-dollar Ad: $5.00
Send in an ad that is up to 50 words with a picture and we’ll post the prisoner on the main page of his/her state of incarceration. The prisoner's address does not take away from the 50 word count. This option will not give a personalized website, but will place the prisoner on a page that also includes others who have posted $5.00 ads. * No other options on our price list are available with this ad.

Total enclosed: $ _________________

Thank you for your membership. Your ad will be processed in the order in which it was received. Due to the large amount of orders we are receiving at this time ads are usually posted within four weeks of receipt, however, please allow about 6 weeks for completion of processing. Prisoner's photo will be returned.

Please mail this application and payment to:

CellPals!
P.O. Box 3326
Truth or Consequences, NM 87901

We reserve the right to alter all ads for typos and/or inappropriate content.
 

Important! WOULD YOU LIKE FOR US, AFTER WE RECEIVE THIS ORDER, TO NOTIFY THE INMATE THAT HE/SHE NOW HAS AN ACCOUNT WITH US AND THAT IT IS OK AT THIS TIME TO SEND IN THEIR BIOGRAPHY, PICTURES/ART, ETC, ON THE STAMPED-PAID ORDER FORM THAT WE WILL ENCLOSE?

__________________________ WRITE YES OR NO and include this section with order

(When we send the order form to the inmate we will outline what has been purchased by you, for the inmate, and what he/she needs to send in)
If you don't want us to send in an order form we will assume that you have informed the inmate that the site has been purchased and have advised the inmate of what materials to send us. We will simply hold this order, place it in waiting status, and wait for the inmate to send in the required materials. Once we receive the information from the inmate we will complete the order. Once completed both you, and the prisoner, will receive completion confirmation. Thank you!