Volunteer Application : Offender Aid and Restoration

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Personal Information
Name
First Middle Last
Address
Street Address Apt. No. City State Zip Code
Home Phone
Cell Phone
Office Phone
Preferred Contact
Email
Enter Email Confirm Email
Information Needed for Criminal Background Check
Date of Birth*
MM
DD
YYYY
Place of Birth*
Ethnic Origin*
Gender*
Are you a U.S. Veteran?*
Social Security Number
Education
Highest Level of Education Achieved
Course of Study
Other Training or Certifications
Employment History
Present Employer
Employer Address Dates (From - To) Position
Previous Employer
Employer Address Dates (From - To) Position
Previous Employer
Employer Address Dates (From - To) Position
Previous Employer
Employer Address Dates (From - To) Position
May we use your name in grant applications from your employer?

Volunteer Experience
Organization
Employer Dates<br/>(From - To) Name of Supervisor Phone Type of Work Performed
Organization
Employer Dates<br/>(From - To) Name of Supervisor Phone Type of Work Performed
Organization
Employer Dates<br/>(From - To) Name of Supervisor Phone Type of Work Performed
Faith Community (optional - for grant purposes)
Name of Community
Name of Leader/Contact Person
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Website
Personal Background
Have you ever been arrested, convicted and/or incarcerated for a crime?
If yes, please explain and include details on the date, place, charge, fines or sentence for each charge.
Have you ever been admitted to any correctional facility, jail or prison, at the local, state, or federal level for any criminal offense, employment or on a volunteer basis?
If yes, please explain.
Do you have any health condition that would require an accomodation?
If yes, please explain the accomodation.
Have you ever volunteered and/or been employed in the criminal justice system?
If yes, where and what did you do?
Do you know anyone who is currently incarcerated in the Arlington County Detention Facility?
If yes, please explain.

Statement of Agreement
I am interested in serving as an OAR volunteer. I understand that, in order to become a volunteer, I will:*
- Authorize a criminal background check by the Arlington County Detention Facility (Note: A criminal record does not preclude individuals from volunteering; we do require that applicants with records submit a written statement of explanation);
- Abide by the rules and regulations of OAR, the Arlington and Alexandria Detention Facilities;
- Permit OAR staff to contact references listed on this application;
- Complete mandatory twenty (20) hour training;
- In addition, I will hold OAR blameless if I incur injury related to my OAR work.