Film Showings of Solitary Confinement: Torture in Your Backyard

1.

Thank you for letting us know that your congregation or group plans to host a screening of the video, "Solitary Confinement: Torture of Your Backyard."

Please take a few minutes to fill out this form and help us keep track of and support congregations across the country who are spreading the word about the dangerous overuse of solitary confinement in U.S. prisons.

If you have any technical problems in completing this form, please contact Heather Rice, NRCAT's Director of U.S. Prisons Policy & Program, at hrice@nrcat.org or 202-547-1920.

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* 1. Please tell us who you are and which congregation or group will be hosting the screening:

Your Name:

Your Phone #:

Your E-mail:

Congregation or group:

Faith group/denomination (write N/A if not applicable):

City (where film is shown):

State (use abbrev, e.g. CT or TX):

Zip Code:

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* 2. Has this congregation or group participated in other NRCAT projects?

Yes

Unsure

If "Yes", please identify one or two of the activities:

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* 3. Will you be facilitating the discussion? Links to NRCAT's interfaith disucssion guide and other resources are available on www.nrcat.org/backyard.

Yes

Unsure

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* 4. Have you already held or scheduled the screening?

Yes

If "Yes", please indicate the date:

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* 5. How many participants attended the screening? If you have not yet held the screening, you are welcome to leave an estimate of your attendance and NRCAT staff may follow up after the date of your event to get updated feedback.

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* 6. Have you already secured a copy of the video?
(If not, you can order a DVD for $5 from www.nrcat.org/backyard)

Yes

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* 7. Did you invite your group participants to endorse NRCAT's Statement Against Prolonged Solitary Confinement after showing the film or if you are planning to show the film, have you printed sufficient petitions pages?
The statement is available at the end of of the interfaith discussion guide or at www.nrcat.org/solitary.

Yes, I provided or plan to provide the statement.

Other (please specify)

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* 8. If you have already showed the film in your congregation or group, are there responses from your group discussion or other comments you would like to share?

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* 9. The best way for us to engage new faith communities in this work is through personal outreach.

Are you planning to reach out to another congregation or group in your town, region or faith group and encourage them to show the video?

Yes

If "Yes", please tell us which congregation(s) or group(s) (name and city) you are thinking of:

Thank you again for showing "Solitary Confinement: Torture in Your Backyard."

If you haven't yet done so, please download a version of the discussion guide at: www.nrcat.org/backyard.

If you have any questions or concerns, please contact Heather Rice at hrice@nrcat.org.

National Religious Campaign Against Torture
110 Maryland Ave. NE, Suite 502
Washington, DC 20002
202-547-1920

Question Title

* 1. Please tell us who you are and which congregation or group will be hosting the screening:

Question Title

* 2. Has this congregation or group participated in other NRCAT projects?

Question Title

* 3. Will you be facilitating the discussion? Links to NRCAT's interfaith disucssion guide and other resources are available on www.nrcat.org/backyard.

Question Title

* 4. Have you already held or scheduled the screening?

Question Title

* 5. How many participants attended the screening? If you have not yet held the screening, you are welcome to leave an estimate of your attendance and NRCAT staff may follow up after the date of your event to get updated feedback.

Question Title

* 6. Have you already secured a copy of the video?(If not, you can order a DVD for $5 from www.nrcat.org/backyard)

Question Title

Question Title

* 8. If you have already showed the film in your congregation or group, are there responses from your group discussion or other comments you would like to share?

Question Title

* 9. The best way for us to engage new faith communities in this work is through personal outreach. Are you planning to reach out to another congregation or group in your town, region or faith group and encourage them to show the video?

* 6. Have you already secured a copy of the video?
(If not, you can order a DVD for $5 from www.nrcat.org/backyard)

* 9. The best way for us to engage new faith communities in this work is through personal outreach.

Are you planning to reach out to another congregation or group in your town, region or faith group and encourage them to show the video?