DC Detention Visitation Application Form
Please complete this form to apply to be a volunteer with the DC Detention Visitation Network
Email address *
Personal Information
Full Name
Your answer
Street Address (Incl. Apt #) *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Primary Phone *
Your answer
Alternate Phone
Your answer
Language Proficiency (elect all that apply) *
Required
Organization/ Community/ Congregation (if any)
Your answer
Emergency Contact (Name, relationship, phone) *
Your answer
Your Interests
What would you like to do as a volunteer? *
Your answer
How did you hear about DC Detention Visitation Network? *
Your answer
Are you interested in being part of the planning/leadership for DCDVN going forward? *
Background Information
* Important Note: If you do not hold a valid immigration status, you may be putting yourself at risk by visiting an immigration detention center.

The following information is requested only for the purpose of permitting detention centers to perform background checks.  You are not required to provide it, but your failure to do so may mean that we are unable to bring you as a volunteer into any of the detention centers we visit.

List any other names by which you are known or have ever been known: *
If you have never used another name please enter "None"
Your answer
Date of Birth *
Please enter the date as MM/DD/YYYY
Your answer
Your race or ethnicity *
Have you ever been convicted of a law violation other than minor traffic offenses? *
If yes, please describe, including location and date of conviction: *
If No, please enter "None"
Your answer
Acknowledgement and Permission to Conduct Records Check
All of the information provided in this application is true and correct to the best of my knowledge. I understand that any false or misleading information given by me may disqualify me from consideration or result in my inability to volunteer again if discovered at a later date.



By submitting this form I hereby give my permission to DC DVN to share my personal information as needed with ICE and detention center staff who manage immigration detention facilities and operations.

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