DC Detention Visitation Application Form
Please complete this form to apply to be a volunteer with the DC Detention Visitation Network
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Street Address (Incl. Apt #)
Language Proficiency (elect all that apply)
Organization/ Community/ Congregation (if any)
Emergency Contact (Name, relationship, phone)
What would you like to do as a volunteer? - choose all that apply.
Visit - Worcester County Jail, Snow Hill, MD
Visit - Dorchester County Detention Center, Cambridge, MD
Visit - Farmville Detention Center, Farmville, VA
Visit - Caroline Detention Facility, Bowling Green, VA
Be a pen pal
Give public presentations and represent the organization at volunteer fairs and events
Help with logistical needs like transportation and temporary housing
How did you hear about DC Detention Visitation Network?
Are you interested in being part of the planning/leadership for DCDVN going forward?
* 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"
Date of Birth
Please enter the date as MM/DD/YYYY
Your race or ethnicity
American Indian or Alaska Native
Black or African American
Native Hawaiian or Other Pacific Islander
White, Hispanic or Latino
White, Not Hispanic or Latino.
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"
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.
Send me a copy of my responses.
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