Form CIV1P "Activity Proposal and Curriculum Review Process for Volunteer-Directed or Facilitated Program" - New Hampshire

What Is Form CIV1P?

This is a legal form that was released by the New Hampshire Department of Corrections - a government authority operating within New Hampshire. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • The latest edition provided by the New Hampshire Department of Corrections;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form CIV1P by clicking the link below or browse more documents and templates provided by the New Hampshire Department of Corrections.

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Download Form CIV1P "Activity Proposal and Curriculum Review Process for Volunteer-Directed or Facilitated Program" - New Hampshire

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New Hampshire Department of Corrections
Office on Citizen Involvement and Volunteers
A
P
C
R
P
CTIVITY
ROPOSAL AND
URRICULUM
EVIEW
ROCESS
V
-D
F
P
FOR
OLUNTEER
IRECTED OR
ACILITATED
ROGRAM
PRINT OR TYPE ALL RESPONSES
Attach additional pages and support documents to thoroughly present this proposal.
Program Title
Activity/Event/Course
Program
Particulars
specific details of
curriculum, syllabus,
handouts, lesson plans,
resource and reference
materials
Program is:
New to Division
Change from current
activity
Special Event
Target Population
Inmate
Gender
Anticipated # of
Other Participant Characteristics
Classification
Participants
Of criminal offenders
Outcomes
Expected
for
this program
Proposal
Signature
Date
Prepared by
Program
Affiliation
Endorsing Entity or
Outside Authority
Address
Phone
Contact
Form CIV 1P
page 1 of 2
New Hampshire Department of Corrections
Office on Citizen Involvement and Volunteers
A
P
C
R
P
CTIVITY
ROPOSAL AND
URRICULUM
EVIEW
ROCESS
V
-D
F
P
FOR
OLUNTEER
IRECTED OR
ACILITATED
ROGRAM
PRINT OR TYPE ALL RESPONSES
Attach additional pages and support documents to thoroughly present this proposal.
Program Title
Activity/Event/Course
Program
Particulars
specific details of
curriculum, syllabus,
handouts, lesson plans,
resource and reference
materials
Program is:
New to Division
Change from current
activity
Special Event
Target Population
Inmate
Gender
Anticipated # of
Other Participant Characteristics
Classification
Participants
Of criminal offenders
Outcomes
Expected
for
this program
Proposal
Signature
Date
Prepared by
Program
Affiliation
Endorsing Entity or
Outside Authority
Address
Phone
Contact
Form CIV 1P
page 1 of 2
New Hampshire Department of Corrections
Office on Citizen Involvement and Volunteers
Attach additional pages and support documents to thoroughly present this proposal.
Volunteer Leaders /
Address
Phone
Email
Outside Facilitators
Lead Outside
Participants
Other Volunteer
Participants
Requested Scheduling and Facility Support
Subject to facility/security constraints
Location
Division Name:
acility
Room or Site Requested
Prison or Correctional f
Time
How Often
Day(s) of Week
Hours:
Program Cycle or
Start & End
times
Duration
Frame
Equipment &
Audio-Visual
Room set-up -
Food Service
Paper Goods
equipment
tables & chairs
Supplies
From DOC
Carried in/out
Donated (per
PPD 3.30 thru
warehouse)
++++++++++++++++++++++++++++++++++++++++++++++++++++++
NH DOC STAFF ONLY - - - Division Review & Disposition Process
Modify activity proposal as necessary
1.
Staff Member
Print Name
Title
Phone Number
Assigned/
Accountable
2.
Bureau/Office
Accept
Print Name
Signature
Date
Recommendation
Reject
Volunteer credential/qualification requirement
Volunteer gender restriction
None
Male Only
Female Only
3.
Division Director
Accept
Signature
Title
Date
or Designee
Reject
4.
Forwarded to NH DOC Volunteer Activities Office:
a) preparation of Volunteer Position Description & b) records retention
Form CIV 1P
page 2 of 2
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