College Initiative Interest Form

College Initiative (CI) is a college access program and community for students with past criminal legal system involvement who are committed to pursuing higher education.

Please complete the interest form below and our Intake Specialist will contact you within 2 business days of submission to share more about our program and discuss a timeline for joining.

If you have any questions, feel free to reach out to our Director of Outreach and Intake, Darryl Epps, at

depps@jjay.cuny.edu or (212) 393-6010.

Fields marked with an * are required

First Name

Last Name

Phone

Email Address

If "Other" please specify

If "Other" please specify

If from "Parole Officer" please specify their name and contact details if known (if unknown, please type: unsure

If from "Probation Officer" please specify their name and contact details if known (if unknown, please type: unsure

If from "P2CP", please specify their name(s)

Denisse MartinezMelannie InsignaresCarla BarrettOther

If other, please specify:

Have you ever been a part of College Initiative before?

Anything else you want to tell us?

If you are a provider or family member who is referring an applicant to College Initiative, please list your name and your relationship to the applicant.

Contact Information