Attendance Request Form – Survivor Speakout Victim Impact Panel – Hendricks County 4H Complex & Conference Center

This form is for OFFENDERS to request to attend Survivor Speakout Victim Impact Panel IN PERSON. Once the form has been submitted you will be directed to a page to pay your $45.00 fee with a debit or credit card securely through PayPal.

Read the guidelines to attend in person

Wednesday, December 6, 2023 – 6:30pm-8:30pm
Wednesday, March 6, 2024 – 6:30pm-8:30pm
Wednesday, June 5, 2024 – 6:30pm-8:30pm
Wednesday, September 4, 2024 – 6:30pm-8:30pm
Wednesday, December 4, 2024 – 6:30pm-8:30pm

Location – Hendricks County 4H Complex & Conference Center

There are also ONLINE victim impact panels available to attend as well as in person panels at the Brownsburg Public Library.

Do not call or contact the Hendricks County 4H Complex & Conference Center for information. Contact Survivor Speakout. 317.289.3242

You will receive a confirmation email after submitting this form. If you do not receive the confirmation email, check your spam/junk folder.

Your Personal Information

Request the date you would like to attend Survivor Speakout IN PERSON

On what charges were you arrested?

If you chose 'Other' above, please tell us what you were charged with

Your probation officer and date your probation ends

If your probation officer's name is not listed, enter their name here
If you are not sure of the exact date, choose the last day of the month your probation ends

Who is the judge presiding over your case?

If you know the name of your judge, but they are not on the list, enter it here

County information