Jail Ministry Volunteer Application Step 1 of 2 50% Your Personal InformationFull Name(Required) First Middle Last Maiden NameMaiden NameAddress(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Date of Birth(Required) MM slash DD slash YYYY Phone(Required)Gender(Required) Male Female Driver’s License #Occupation(Required)Email Address(Required) Are you interested in learning more about our Circles of Support program? Yes No Have you ever been convicted of a felony or are you currently on probation or parole?(Required) Yes No Please explain(Required)Describe why providing services in the jail to inmates interests you(Required)Volunteers must NEVER provide service alone. Please identify who you would like to volunteer with and which inmates you would like to serve; males, females, or both. If you do not have someone to volunteer with, we will do our best to match you with someone from a similar faith background.Please identify any previous or current volunteer experiencePlease list a faith community leader (Iman, Rabbi, Pastor, Prayer Leader, Priest, etc.) who will endorse your representation as a volunteer in the jail (If you are the leader of your faith community, just note your role.)Name(Required)Phone(Required)Faith Community(Required)Email(Required) Volunteer AgreementJAIL VOLUNTEER RULESSHERIFF’S DEPT. GUIDELINES Revised 02/20/02 1. Safety and security are the top priorities for everyone working in the La Crosse County Jail. Safety and security are the primary considerations for every action and decision in the Jail. 2. Individuals will not be denied access to the volunteer program based solely on sex, race, national origin, physical handicap, religion, or political belief. 3. Individuals interested in Jail Ministry programs must submit a written application to the Jail Chaplain and will be interviewed by the Jail Chaplain before Jail Administration approves the application. Individuals interested in other Jail volunteer programs must submit a written application to Jail Administration and will be interviewed and approved by Jail Administration. Sheriff’s Department Personnel will conduct a criminal history and background check on all volunteer applicants. Volunteer applicants with pending criminal charges or a history of criminal convictions may be disqualified. Application information must be kept current by reporting changes to the Jail Chaplain or Jail Administration as soon as possible. 4. Volunteers must be at least 21 years old. 5. Volunteers must be of good moral character. 6. Volunteers must sign in and out of the visitor log register. 7. Volunteers must follow all written and verbal directions given by the Jail staff. 8. Never report for volunteer duty at the Jail under the influence of alcohol or drugs (unless prescribed by a physician). 9. Never bring in or give personal property to an inmate. Never take any personal property from an inmate. 10. Immediately report all breaches of security, threats of suicide or escape attempts/plans to Jail staff. Terms and Conditions(Required)I certify that the above information is current and correct to the best of my knowledge. I authorize the La Crosse County Sheriff’s Department to conduct a criminal history background check. I acknowledge that I have read through the jail rules, I certify that I understand the rules and will abide by them. I further understand that violation of any of the rules may result in the suspension and/or termination of the privilege of entering the jail and/or possible criminal charges if the violations are criminal in nature. I am aware of the nature of the La Crosse County jail and will take due caution in performance of my duties. I will not hold the Sheriff’s Department responsible for areas beyond their control. I agree to take on all of the duties associated with being a volunteer at the La Crosse County Jail. I agree to the above terms and conditions and this check serves as my agreement and signatureAny questions please contact: Chaplain (608) 785-9772 Chaplain@lacrossejailministry.org Δ
