Volunteer Application Form for CCCC

Cuyahoga County Corrections Center

Volunteer Application Form (Background Check Authorization)
The Cuyahoga County Corrections Center (CCCC) is the second largest Jail in the state. It is a full service Jail that provides superior care and management of over 26,000 inmates annually.

We encourage the participation of volunteers who support our
mission and are willing to contribute. The information provided through this form will be kept confidential and will help us determine the
most satisfying and appropriate volunteer opportunity for you.
Dear Applicant,

Thank you for your interest and willingness to volunteer in Cuyahoga County Correction Center (CCCC). Please review the following description and requirements before completing the application for CCCC Volunteer.
1. Minimum age required to volunteer is 18 years.
2. You must complete the Wavier and Release Ability form before you start volunteering in the CCCC. The link to read and complete that notice is provided below.
3. We encourage and expect that you volunteer in a consistent manner and request you to sign up at least once a month.
4. A volunteer is required to participate in CCCC operations for at least 6 months before a letter of recommendation can be issued if needed.
5. Each volunteer is required to participate in an orientation and training at the CCCC prior to the start as a CCCC volunteer.
6. Please note that submission of this application does not guarantee a volunteer position. We will review your application and get back to you with an answer as soon as possible.
7. Before submitting the application for volunteer at CCCC, you must read and understand the wavier and releaase of liability form.
Please click on this link to access the wavier and release of liabiilty form.
I have reviewed and understood the policies and requirements of the Cuyahoga County Correctional Center.*

YesNo
I have reviewed and understood the waver and release of liability form.*

YesNo
- Name*
  
  PrefixFirst NameMiddle NameLast Name
- Birth Date*
  
  MonthDayYear
- Social Security Number*
- Email
  example@example.com
- Phone Number*
  
  Area CodePhone Number
- Home Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Driver's License #
- State of Ohio Id#
- Please provide emergency contact information for two (2) people below.*
- About You
  
  Self-Identification is important, and we understand that we each have our own understanding of the words used to describe our own experiences. We require the following information for the purposes of helping our staff use the most respectful language when addressing you. So that we can best honor your identity and experiences, please answer the following questions.
- Sex Assigned at Birth*
- Select the term(s) with which you most identify.*
  
  AgenderCisgender (non-trans) ManCisgener (non-trans) WomanGender Non-conformingGender VariantGenderqueerIntersexNon-binaryNot ListedTransgender ManTransgender WomanOther
- Selec the pronouns you use.*
  
  She/Her/HersHe/Him/HisZe/Hir/HirsThey/Them/TheirsNo PronounNo PreferenceNot Listed
- Race (Select all that apply)*
  
  American Indian/Alaska NativeBlack/African AmericanWhite/CaucasianAsian IndianChineseFilipinoJapaneseKoreanVietnameseNative HawaiianGuamanian/ChamorroSamoanOther Pacific IslanderOtherDecline to Answer
- Ethnicity*
  
  Non-Hispanic/LatinoDominicanCubanMexican, Chicano/aPuerto RicanOther Hispanic/LatinoDecline to Answer
- Program Type*
- Program Name*
- Regular Volunteer
  
  YesNo
- Guest Volunteer
  
  YesNo
- Agency Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Supervisor's Name*
  
  First NameLast Name
- Supervisor's Phone Number*
  
  Area CodePhone Number
- Do you have any volunteering experience in a correctional setting? If yes, please describe. If no, please write N/A below*
- Why are you interested in becoming a volunteer? *
- Please indicate your availability to volunteer at the Cuyahoga County Corrections Center.
- VOLUNTEER TERMS AND CONDITIONS
  1. I agree to arrive at my agreed upon shift on time, and to advise the Cuyahoga County Correctional Center Associate Warden Jennifer Frame or designee well in advance if my availability for rostered shifts changes.
  2. I agree to work under the guidance and supervision of Cuyahoga County Correctional Center staff.
  3. I agree to report 15 minutes before my scheduled time in order to clear security screening and offer the opportunity for scheduled staff to inform me of particulars related to the volunteer role and the venue.
  4. I will not arrive for a scheduled shift under the influence of alcohol or drugs.
  5. I agree to adhere the Cuyahoga County Correctional Center's policies, procedures, and dress code while on premises and during my time volunteering.
  6. I agree to advise Cuyahoga County Correctional Center staff if I am unable or uncomfortable to complete tasks that have been assigned to. We will be understanding of these requests, just give us as much notice as possible.
  7. I agree to inform the on-duty supervisor and Associate Wardern Jennifer Frame or designee immediately of any injuries sustained while undertaking volunteering activities.
  8. I will do my best to provide correct information and a positive attitude to all inmates and staff throughout the Cuyahoga County Correctional Center.
  9. I agree to work in a constructive and cooperative way with Cuyahoga County Correctional Center staff and comply with any safety procedures as requested.
  10. I understand that if I am unable to complete my shifts, if I fail to comply with directions given by the Cuyahoga County Correctional Center or if an safety concern arises, I may be asked to immediately cease and dissect all activities and leave the Cuyahoga County Correctional Center immediately.
  11. I understand that I am volunteering my services to Cuyahoga County Correctional Center and will not receive any remuneration for my services.
  12. I understand that if I am convicted of a crime, awaiting trial for any criminal offense, or have initiated an act of violence in the workplace that I am to notify Cuyahoga County Correctional Center Associate Warden Jennifer Frame or designee immediately.
- I have read and agree to the terms and conditions.*
  
  YesNo
- Pursuant to the Prison Rape Elimination Act, the Cuyahoga County Correction Center (CCCC) is required to take certain steps to ensure compliance with the law with respect to those who may have contact with inmates. Specefically, pursuant to 28 CFR 115.17(d):
  
  The department shall also perform a criminal background check before enlisting services of any contractor who may have contact with inmates.
  
  I hereby acknowledge the requirments for CCCC to conduct a criminal background record check as required by law. I understand that all materials pertaining to this background check becomes the propery of CCCC and will not be returned to me but will be maintained in a secure manner in accordance with applicable laws and policies.
  
  The authorization shall remain valid for 2 years of my services with CCCC.
- I have reviewed the information related to the Prison Rape Elimination Act and understand that my information will be used to complete a background check.*
  
  YesNo
- Signature
- Date
  
  MonthDayYear
  Date
- Should be Empty:

Cuyahoga County Corrections Center