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Integrated Victim Ser...
Victim Impact Panels
Victim Impact Panel Request
Victim Impact Panel Request
Note: This form is to be utilized for all Victim Impact Panel requests received by the TxCVC. This form must be submitted no less than 30 days prior to the requested panel date. All requests are subject to approval.
Victim Impact Panel Request
Requester Details
First Name
Last Name
Organization Name
Email
Phone
Panel Details
Address
City
State
Zipcode
Requested Date
First Alternate Date
Second Alternate Date
Third Alternate Date
Fourth Alternate Date
Estimated Number of Attendees (1-5000)
Proposed Audience
Criminal Justice Professionals
Offenders
Other
Purpose of the Panel
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