Completing the questions below is required to express your interest in participating in the Rise Up! Washington Cannabis Record Clearing Day. Upon review of your answers, if you qualify and if space is still available, you will be notified via email of your confirmed registration for the program. (You will also be notified if you are not registered.) The program takes a maximum of 4 hours of your time on Saturday, May 20. The program will clear your most recent cannabis offense only. 

* 1. Full name (first name, middle name, last name)

* 2. Date of birth (MM/DD/YYYY)

* 3. Are you available to participate in the Record Clearing Program by attending the workshop in Seattle on May 20 from 10am PST to 2pm PST?

* 4. In what Washington county were you convicted of your cannabis crime? (If you have multiple cannabis convictions, list the county for the most recent cannabis conviction)

* 5. Was your most recent cannabis conviction a felony?

* 6. If yes to the above, were you convicted of your most recent felony cannabis charge prior to May 20, 2012?

* 7. Have you completed all requirements of your cannabis conviction sentence, including time or probation served, community service, and all financial obligations?

* 8. If you have not completed all sentencing requirements, please explain why not and what is outstanding?

* 9. Was your cannabis conviction for driving under the influence?

* 10. Do you currently have criminal charges pending against you in ANY state or federal court?

* 11. Have you been convicted of a non-cannabis offense after the date of your most recent cannabis conviction?

* 12. Please provide your email address

* 13. How did you hear about this event?

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