1. I have been provided a list of approved items and dress code for the facility.
2. In visiting the Department of Corrections, I may be in circumstances involving risks or hazards. I willingly and knowinglyaccept these conditions.
3. I agree to:
   1. Take nothing, including letters, in or out of any correctional center without approval from administration.
   2. Respect the confidentiality of records and other privileged information.
   3. Refrain from using abusive or profane language.
   4. Refrain from taking photographs on institutional property for any purpose without specific permission from the administration.
   5. Refrain from giving/leaving anything behind for use by an offender without approval from administration.
   6. Refrain from inappropriate signs of affection.
   7. Obey any staff member order.
   8. Not discriminate.
   9. Refrain from racially inflammatory speech, disparaging other religions or directly addressing issues of confinement.
4. I do not have a personal relationship with any offender in Missouri Department of Correction's custody at the facility that I amaccessing.
   1. If a personal relationship exists with any offender in Missouri Department of Correction's custody, it must be disclosed to thesite coordinator at the facility I am accessing.
5. I am not on any offender visiting list at the facility that I am accessing.
6. All vehicles will have doors locked, windows up and key removed from ignition.
7. No drugs are allowed in the institution except a personal one-day supply of prescribed medication in the originalprescription container.
8. No tobacco products or electronic cigarettes (e-cigarettes) are allowed in all department facilities (except for authorized religiouspurposes or in designated smoking areas) and in all state owned or leased vehicles in accordance with the non-smoking andtobacco free department procedure.
9. If applicable, I will complete all training as required by the department.
10. I authorize Missouri Department of Corrections to conduct a Criminal History Check Screening.
11. I understand I cannot enter the facility until the site coordinator has received this application, it has been approved, and myname has been added to the Approved Entry Roster.
12. Failure to abide by this agreement or violation of any state or federal law during my visit may result in sanctions includingarrest and prosecution.
13. I agree to comply with departmental drug and tuberculosis testing, as applicable.

Effective August 2013, the Department of Corrections must be in compliance with the final standards implementing the Prison Rape Elimination Act (PREA), issued by the U.S. Department of Justice. The following questions are being asked of all applicants who may have contact with offenders as part of their regular job or volunteer duties.

(2) CRIMINAL CHARGES: Have you pled guilty to or been found guilty of engaging in sexual activity or attempted sexual activity involvingforce or inflicted upon a person unable to consent? This includes, but is not limited to, the following crimes:

• Forcible Rape (or Attempted Forcible Rape)
• Statutory Rape (or Attempted Statutory Rape)
• Sexual Assault
• Forcible Sodomy (or Attempted Forcible Sodomy)
• Statutory Sodomy (or Attempted Statutory Sodomy)
• Child Molestation
• Deviate Sexual Assault
• Sexual Misconduct Involving a Child
• Sexual Contact with a Student
• Sexual Misconduct
• Sexual Abuse
• Sexual Contact with a Prisoner or Offender

(3) CIVIL/ADMINISTRATIVE CASES: Have you been found to have engaged in sexual activity or attempted sexual activity involving force or inflicted upon a person unable to consent, by a civil or administrative body? This includes any actions taken upon a professional license or a professional registry and any internal administrative investigation results.

I certify the information contained in this appendix is correct to the best of my knowledge and I understand that falsification of this information is grounds for disqualification from the selection process or dismissal from employment.