Victim Services Volunteer

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Email*

example@example.com

Name*

First NameLast Name

Phone Number*

Please enter a valid phone number.

Emergency Contact Relationship*

Are you bilingual?*

YesNo

If yes, in what language(s)?

Are you retired?*

YesNo

Name of Current Employer

Occupation

Are you a student?*

YesNo

Have you ever been convicted of a felony? If yes, you are NOT eligible to be in this program.*

YesNo

Have you ever been arrested?*

YesNo

If yes, please provide date.

Date

Charge(s)

How did you hear about this program?*

I certify that I meet the following program requirements.

I am 21 years of age or older.
I currently have and will maintain reliable transportation.
I currently have and will maintain state required vehicle insurance.
I currently have and will maintain a working cell phone.
I am able to make a one-year commitment to the TCSO Victim Services Volunteer Program.
I am able to commit to four 4-hour shifts per month.
I am able to complete the required program training.

Acceptance as a Victim Services Unit Volunteer will include the receipt of information related to the law enforcement mission of the Travis County Sheriff's Office. As such, some of the material presented will be privileged and confidential in nature. Due to the sensitivity of this information, it is necessary for the Travis County Sheriff's Office to conduct background checks to determine the suitability of those persons desiring to become Victim Services Unit Volunteers.

I certify that I have made no willful misrepresentation in this application, nor have I withheld information in my statements and answers to questions. I understand that any misrepresentation may cause my application to be rejected. My electronic signature below confirms my knowledge that this information will be investigated, with my full permission at the time of application and at any time during my participation with the Victim Services Unit Volunteer Program.

Signature*

Victim Services Volunteer

Contact Information

Emergency Contact Information

Language

Employment

Criminal History

Interest

Certification