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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
Home
Office
Cell
Email
Enter Email
Confirm Email
Information Needed for Criminal Background Check
Date of Birth
*
MM
DD
YYYY
Place of Birth
*
Ethnic Origin
*
Gender
*
Male
Female
Are you a U.S. Veteran?
*
Yes
No
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?
Yes
No
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
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Greenland
Grenada
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Sudan, South
Suriname
Swaziland
Sweden
Switzerland
Syria
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Tanzania
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Tonga
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Ukraine
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United Kingdom
United States
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Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Yemen
Zambia
Zimbabwe
Country
Website
Personal Background
Have you ever been arrested, convicted and/or incarcerated for a crime?
Yes
No
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?
Yes
No
If yes, please explain.
Do you have any health condition that would require an accomodation?
Yes
No
If yes, please explain the accomodation.
Have you ever volunteered and/or been employed in the criminal justice system?
Yes
No
If yes, where and what did you do?
Do you know anyone who is currently incarcerated in the Arlington County Detention Facility?
Yes
No
If yes, please explain.
References - Two work and one personal (Do not include relatives)
Work Reference
Name
Address
Daytime Phone
Relationship
Work Reference
Name
Address
Daytime Phone
Relationship
Personal Reference
Name
Address
Daytime Phone
Relationship
Additional Information
Please check the subjects and jobs that interest you:
Administrative Assistant
- OAR office support
Community Service
- Working with clients/staff in the office, supervising clients at weekend Community Service events, attending court on behalf of OAR
Jail Services
- Facilitation of educational and therapeutic sessions, guest speaking, proctoring GED exams, computer lab assistance
Reentry Services
- Tutoring, mentoring, intakes, one-on-one work, group work, PREP (Employment Readiness Program), socialization activities, workshops, interviewing incarcerated clients to create a Reentry Plan
Special Projects
- Assisting with special events, advocacy on behalf of OAR, representing OAR at events, fundraising and development activities
Technical Support
- Database development, website development, other technology-related support
Joining the OAR Board of Directors
Other
Have you ever worked/volunteered with current or former offenders before?
Yes
No
If yes, please explain.
List any other skills, hobbies, or interests you have that might be helpful in your volunteer work.
Do you speak any languages other than English?
Yes
No
If yes, which language(s)?
If yes, do you...
Speak fluently
Write
Read
What days and times are you available to volunteer?
How many hours would you like to volunteer? (weekly, monthly, yearly)
How did you learn about OAR's volunteer program? (Check all those that apply)
Arlington Volunteer Website
Alexandria Volunteer Website
Fairfax Volunteer Website
Presentation by OAR staff
OAR website
Other
Are there any types of offenders with whom you would feel more comfortable working with (adult/juvenile, male/female)?
Yes
No
If yes, please explain.
What do you expect to gain and to give as an OAR volunteer?
Emergency Contact #1
Name
First
Last
Relationship
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Greenland
Grenada
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Sudan, South
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Yemen
Zambia
Zimbabwe
Country
Home Phone
Work or Cell Phone
Emergency Contact #1
Name
First
Last
Relationship
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Greenland
Grenada
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Sudan, South
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Yemen
Zambia
Zimbabwe
Country
Home Phone
Work or Cell Phone
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.
Quick Links
Catalogue for Philanthropy
Alternative Sentencing + Diversion
Reentry Services
Volunteer at OAR