Department of Juvenile Justice Department of Juvenile Justice
 

 


Department of Juvenile Justice Volunteer / Intern Application
Date & Time: 

We consider applicants for all volunteer positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, the presence of a non-job related medical condition or handicap, or any other legally protected status.
  Personal Information
 First Name:
 Middle Name:
 Last Name:
 Previous Name or Aliases:
 Date of Birth:    Calendar
 Gender:
 Mailing Address:
 City:
 State:
 Zipcode:
 Contact Number:   (XXX-XXX-XXXX)
 Email Address:
  Education & Current Work Status
 Are you a student seeking internship?
 Degree in Progress (If Student or Intern):
 Current School Name (If Student or Intern):
 Current Field of Study (If Student or Intern):
 Employment Status:
 Current Employer:
 Current Job Title:
  Affiliations
 Religious/Civic/Professional Affiliation:
  Emergency Contact Information
 1. Emergency Contact Name:
 1. Emergency Contact Number:   (XXX-XXX-XXXX)
 2. Emergency Contact Name:
 2. Emergency Contact Number:   (XXX-XXX-XXXX)
  Area of Interest
Tell us which area you are interested in volunteering:








Other skills/talents/experience
   
   
  Availability
Tell us when you are available in volunteering:
Daytime






Evening






# of Hours Available: per/
  Preferred Volunteer Site
  Facility Office:  
  Community Office:  
  Date available to start:    Calendar
  Other Information
List medical or physical conditions that would prohibit / limit you from participating as volunteer with the Department of Juvenile Justice? (if any)

List previous volunteer work (if any)

Have you ever been convicted of anything more than a minor traffic offense? (Criminal History Background will be required prior to working directly with youth)
  Past DJJ References
Have you filed a volunteer application with us before?
If so, when did you last volunteer with us? Calendar
(MM/DD/YYYY)
 
At what DJJ site did you volunteer?
Have you been employed/ a volunteer/ resided with us before or utilized juvenile justice services?
If yes, comments

  References: (one professional and no family members)
Reference Name:
Reference Relationship:
Reference Phone number:   (XXX-XXX-XXXX)
  How did you hear about DJJ's Volunteer Program?
Website
Department of Juvenile Justic Employee
Current or Previous Employer
Career Fair
Other

By checking this box, I certify that information/answers given herein are true and complete to the best of my knowledge. I consent to and authorize any agent of the Department of Juvenile Justice to verify this information. I understand that I will be subjected to a background investigation as a part of the application process.