INDIANA DEPARTMENT OF CORRECTION

By the person's signature on this form, he/she is aware of and has agreed to a criminal history and warrants check through the Indiana Department of Correction as part of a background investigation. This person is aware that the information received will be in the determination of approval or denial of employment, volunteer and visitation, and that this information will be shared on a need-to-know basis. Please print clearly and provide the most accurate information.

Thank you for your interest in being a special guest at this facility either as an individual or representing a group. The signer of this form and State Form 33062, Application for Special Guest, is considered to be acting as the group leader or individual between the organization and the facility. In this capacity you are responsible to advise all organization members, if applicable, who may be participating in the special program to agree to the following:

1. All individuals entering a Department of Correction facility may be subject to a criminal background and warrants check at the discretion of the Warden.
2. Trafficking with offenders is prohibited. Everyone entering the facility has read and agrees to State Form 41465, Statement of Trafficking Laws and Authorization for Search.
3. Everyone must abide by the Prison Rape Elimination Act (PREA) guidelines. Everyone entering the facility has read and agrees to the information in the I DOC-issued PREA brochure and agrees to all PREA standards.
4. Every individual at the time of entry will be required to show acceptable identification. This may include a driver's license or other government-issued identification.
5. Individuals may not enter a Department of Correction facility while under the influence of alcohol or illegal substances. All types of tobacco, tobacco paraphernalia, and any cellular or electronic devices are strictly prohibited. Any medication, physical or medical condition, or equipment must be approved prior to arriving at the facility.
6. All individuals must be at least eighteen (18) years of age unless special approval has been received by the Warden.
7. All individuals entering the facility are subject to search of their person, personal property, and vehicle while on Department of Correction grounds.
8. All individuals entering the facility must be aware of the potential dangers, including possible injuries, being taken hostage, and that they may be held liable for any negligent actions or willful disregard of the Department's or facility's rules or procedures which could result in the loss of property or life or injury to themselves or others.

By signing this form, you agree to the items listed above, and if you are representing a group or organization, you agree to distribute the necessary information tc every member and acknowledge that they agree to the items above as well. If any individual does not agree to the items above, they are not permitted into the facility.

Please sign and date this form and complete State Form 33062, Application for Special Guest, and return to the attention of the sender with the name of every individual in your group (if applicable) that will be participating in the special program. If both forms are approved, the name(s) will be submitted to the Warden and a Gate Release will be issued for the individual(s) and any items approved. For security reasons, individuals whose names do not appear on the list will not be permitted into the facility. If any individual on your submitted list is not approved, you will be notified prior to the date of the program.

Indiana Department of Correction Interview Request Form

I hereby grant permission to the Indiana Department of Correction to make use of my name, comments, still or motion pictures, voice recordings and/or videotape
of me for any legitimate purposes including publication in news media, website postings, *social media and for professional and internal or external institutional purposes.

I hereby agree to release, defend and hold harmless the State of Indiana, the Indiana Department of Correction, and its agents, officers and employees from all claims and suits arising from or caused by this interview, including damages for libel, slander, invasion of the right of privacy or any other claim based on the use of said material gained from this interview.

I relinquish and give to the Indiana Department of CoITection all right, title and interest that I may have in the finished product, copies thereof, and materials used in its production; and further grant the Indiana Department of Correction the right to give, transfer and exhibit said product or any portion, copy or facsimile thereof, for any purpose it deems necessary and proper.

The above consent is given by me freely and voluntarily without any promises, threats or duress, and I understand that my participation is contingent upon the approval of my parent or legal guardian (if the offender or staff member is a minor or an adult with a guardian). I reserve the right to terminate the interview or participation in a media visit at any point before or during the interviewing session or media visit.

Notice: Incarcerated persons who are a party to any pending or anticipated legal proceeding are advised to notify their attorney prior to conducting a media interview. 

*Social media includes, but is not limited to: Facebook, Twitter, lnstagram, Linkedln, etc.

The following Indiana Statutes are brought to your attention. As a person desiring to enter a correctional facility, either as an employee or for other approved purposes, it is important to understand the content of these laws.

Indiana Code states:
(b) Except as provided in subsection (d), a person who, without the prior authorization of the person in charge of a penal facility or juvenile facility knowingly or intentionally:
(1) delivers, or carries into the penal facility or juvenile facility with intent to deliver, an article to an inmate or child of the facility;
(2) carries, or receives with intent to carry out of the penal facility or juvenile facility, an article from an inmate or child of the facility; or
(3) delivers, or carries to a worksite with intent to deliver, alcoholic beverages to an inmate or child of a jail work crew or community work crew; or
(4) possesses in or carries into a penal facility or a juvenile facility:
(A) a controlled substance; or
(B) a deadly weapon;
commits trafficking with an inmate, a class A misdemeanor.

(c) If the person who committed the offense under subsection (b) is an employee of:
( 1) the department of correction; or
(2) a penal facility;
and the article is a cigarette or tobacco product (as defined in Indiana Code), the court shall impose a mandatory five thousand dollar ($5,000) fine under Indiana Code, in addition to any term of imprisonment imposed under Indiana Code.

(d) The offense under subsection (b) is a Level 5 felony if the article is:
(1) a controlled substance; or
(2) a deadly weapon; or
(3) a cellular telephone or other wireless or cellular communications device.

A person who commits a Class A misdemeanor shall be imprisoned for a fixed term of not more than one (1) year; in addition, he/she may be fined not more than five thousand dollars ($5,000). A person who commits a Level 5 felony shall be imprisoned for a fixed term of four (4) years, with not more than four (4) years added for aggravating circumstances or not more than two (2) years subtracted for mitigating circumstances. In addition, he/she may be fined not more than ten
thousand dollars ($10,000).

It is a Class C infraction for a person to furnish an alcoholic beverage to a person confined in a penal facility. It is unlawful, also, for a person who has charge of a penal facility to knowingly permit a prisoner confined within his/her jurisdiction to receive an alcoholic beverage unless it has been prescribed by a physician as medicine for the prisoner or unless it is distributed as sacramental wine for a religious purpose by a minister, priest, or rabbi.

A person who commits a Class C infraction may be fined not more than five hundred dollars ($ 500).

I, the undersigned, have read and understand the above statutes. I recognize the potential danger of contraband or prohibited property of any nature entering or leaving the I do hereby express my willingness to submit to a thorough search of my person, articles in my possession or any vehicle that I may operate on the grounds of the facility at any time that the Facility Head or designee authorizes. Such searches may include work areas, post assignment, and my living quarters, if on State property.

I understand that refusal to submit to such a search shall be cause to be refused entrance to the facility or to be removed from a facility and may constitute grounds for disciplinary action or referral for prosecution.

1. If you have a friend or relative incarcerated here, you need to report it beforehand.
2. Dress Code: No clothing with holes, sagging jeans, shorts, tank tops, low-cut or see-through shirts, tight pants, stretch pants, etc. No open-toed shoes or sandals. Footwear must cover the foot. If dressed in any of these items, entrance to the facility will be denied. Underwear is required, including bras for females. Dress so as not to attract attention with your appearance. Please remember your purpose here. You are not here to impress the offenders but to help them.
3. You may wear a watch, your wedding ring, and regularly worn jewelry. However, we ask that you leave excessive and over the top jewelry at home. No more than 2 necklaces. No more than 2 sets of earrings and shall not dangle excessively. Other that the foe earrings not other body-piercing jewelry shall be visible. You may wear two rings per hand. (Wedding set considered shall count as one ring.)
4. Umbrellas and jackets/sweatshirts are permitted depending on the weather.
5. You can bring in no more than $40.00 in cash for the vending machines if needed. Also, please leave Your vehicle keys your wallets/purses secured in your locked vehicles or in lockers at the main gate. will also need to be secured in the lockers.
6. You may bring in a drink in a factory sealed bottle or can and/or a sack lunch if needed. (For those staying longer than 4 hours) No aluminum foil, glass, or "take out" containers will be permitted. Now you can also bring in a cup of coffee.
7. On your first visit, you must have a photo ID. Driver's license is preferable. You will also be issued a visitor ID that you will need to be responsible for and keep in your possession until you leave. It will need to be displayed on the outside chest area of your clothing and be visible at all times.
8. Once you receive your permanent volunteer badge, you must be sure to wear it on the outside chest area of your clothing and have it visible at all times. Without your volunteer badge, entrance to the facility will not be permitted.
9. All other items, including program supplies, must have prior gate clearance.
10. Any tattoos that could be gang-affiliated or offensive to someone should be covered. For example, a six-pointed Jewish Star of David is also a symbol of the Vice Lords and possibly the Crips, depending on the color.
11. All vehicles must be locked and secured. No weapons/alcohol/drugs in the vehicle.
12. Cell phones and other electronic devices are prohibited in the facility. Please leave them in your vehicle. Group leaders may request for an electronic equipment gate release.
13. Tobacco and tobacco products (including matches and lighters) are prohibited in the facility.
14. We recommend that you "pat yourself down" before leaving your vehicle to be sure that you do not have any items on you that can cause a security problem. 
15. Everyone will be subject to removing their shoes and jackets and emptying their pockets into a bin that will be run through a scanner (like at the airportEveryone will also be subject to a hands-on frisk search by a same-gender staff member. Any items brought in must be able to be carried on your person or put in clear bags. We have some clear bags available to use for the day. If you have something medical that does not allow to pass through of the metal detector or will make it go off please provide paperwork from the doctor.
16. You must sign in and sign out in the Volunteer Log Book.
17. You must remain with your group or sponsor.
18. Everyone needs to be aware they will be in areas where they will have direct contact with offenders.
19. Do not engage other offenders in conversation (outside of your groupDo not divulge any personal information to any offenders or breach offender's confidentiality. 
20. When/if you hear cat calls from the yards/dorms, do not re-act to them. You may however, bring it to the attention of your group leader who can report it.
21. Custody staff has the last word. Please respect their authority. Occasionally, situations occur within the facility of which we have no control. If a staff person tells you that you need to leave or go to another area, please follow their lea