Fishback Coalition (FBC) Membership Application
(1) Full name at time of conviction:
(2) Inmate number and current prison facility:
(3) Mailing address of facility:
(4) List criminal charges on which you were made parole eligible because the jury was never instructed on the facts regarding the
abolishment of parole. Also include sentences for each conviction.
(5) When the Supreme Court of Virginia decided the case of Richard Fishback v. Commonwealth (June 9, 2000) was your direct appeal final or pending on June 9, 2000?
(6) Provide accurate date(s) when the Court of Appeals of Virginia and The Supreme Court of Virginia denied your petition to appeal:
(7) Were you provided legal counsel by the Commonwealth of Virginia to file your direct appeal?
(8) Have you had a parole hearing since becoming parole eligible?
(9) If your answer to question (8) is yes, provide the reason for being denied parole. If your answer is no, provide your parole eligibility date:
(10) Were you denied executive clemency or commutation of sentence because the Parole Board contacted the Governor notifying them that you have a scheduled parole hearing?
(11) Provide all rehabilitative programs you have completed within the last two years and also any you anticipate on completing in the following year:
(12) Provide all disciplinary infractions you were convicted of within the last five years:
(13) Provide any disciplinary infractions you were convicted of since becoming parole eligible:
(14) Provide an explanation of why you feel the Parole Board should grant you discretionary parole:
(15) Do you feel that the Fishback error in your case is good reason for the Parole Board to grant you discretionary parole?
(16) Provide Contact information for individual(s) authorized by you to speak to the Fishback Coalition on your behalf:
(17) By signing below, you are indicating that the information provided on this document is true and accurate to the best of your knowledge. Any untruthful statements may reflect unfavorably on request; meaning that you have me and your loved ones on the outside working hard to get you out of prison with a second chance.
Signature:____________________________________________ Date:____________________________
On a separate sheet of paper please provide the Fishback Coalition (FBC) any mitigating circumstance you feel would help us prepare a potentially successful parole plan for you . . . I only ask that members of the Fishback Coalition to be truthful and honest.
MAIL ALL APPLICATIONS TO:
Tammie Lawson % W.A.R.P.
Fishback Coalition
PO Box 17 Independence Va. 24248
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