Emergency Contact Information

Have you ever been employed by a state department of correction?

Do you have any family members who work for a state department of correction?

List any offender at the location in which you desire to volunteer that you are currently visiting or knew prior to their incarceration:

Are you related to a victim or friend of any DOC offender or releasee now supervised by your respective department of correction?

Are you volunteering on behalf of a religious organization?

Are you part of a substance abuse program, such as AA or NA?

Are you an undergraduate or graduate student?

Have you ever served time in any adult correctional facility?

Are you currently an active member of a gang?

Have you ever been a member of a gang?

Do you have any criminal charges currently pending?

Are you now or have you ever been placed on probation or parole?

Have you ever forfeited property/bond as a result of being charged with any criminal act?

Do you have a maiden name, alias, or nickname?

Have you ever been convicted of a felony?


How many hours would you like to dedicate to volunteering/mentoring per month?

What day(s) are you available to volunteer?

How often can you volunteer? (1 day a week, 2 days a week, etc.)

For what time period are you able to commit to? (1 week, 1 month, 6 months, 1 year, etc.)

For which location would you like to volunteer?

When you think about volunteering in the prison, what do you envision it to be like?

What impact would you like to make?

Please provide two references, adult, not related to you:

PLEASE NOTE: In submitting this application, an applicant agrees to the following conditions of acceptance as a volunteer:
A. Be 18 years of age or older and submit proof of age
B. Submit proof of credentials when/if providing professional services.
C. Be fingerprinted, if required.
D. Be in possession of a valid driver’s license.
E. Meet attendance and performance commitments.
F. Receive no monetary compensation for his/her services.
G. Complete mandatory volunteer orientation and site-specific orientation, and other training as required.
H. Conform to other Department of Correction policies, regulations, and instructions.
I. Not be on supervision with any correctional agency and supply additional information if requested for FBI and National Criminal History Records Checks.
J. Submit to a drug test, if required