VICTIM IMPACT PANEL REGISTRATION

Name(Required)

First Last

Phone(Required)

Email(Required)

Address(Required)

Street Address City State ZIP Code

Photo ID Upload

Attach a copy of a photo ID below. You can also e-mail your ID to staff@dallashiramduischool.com You can scan your ID in or take a clear photo with your smartphone camera.

License or Photo ID Upload

Max. file size: 256 MB.

Class Schedule & Payment

The Victim Impact Panel is a 2 hour class. Panels are held every other Wednesday, 5PM-7PM. You will receive invitations on the day of the panel.

Select Your Class Date Date(Required)

Victim Impact Panel(Required)

Price:

Credit Card(Required)

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name