Request A DVOMB or SOMB Round Table In Your Area!
Office of Domestic Violence and Sex Offender Management (ODVSOM)
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Judicial District/Counties
*
What time frame would work for a future roundtable? In:
*
3-4 Months
5-6 Months
After 6 Months
What kind of Roundtable are you requesting?
*
DVOMB
SOMB
Other
If you selected SOMB Roundtable, please select an option below
*
Juvenile Focused SOMB Roundtable
Adult Focused SOMB Roundtable
Combined SOMB Roundtable
N/A
If you selected "Other" in the above question, please answer below
Struggles in your area:
*
Strengths in you area:
*
What are you hoping to achieve through this roundtable?
*
Additional Information:
*
Submit
Should be Empty: