Richland County Juvenile Court Volunteer Application

The Richland County Court of Common Pleas, Juvenile Division, considers all applications for volunteer positions without regard to race, color, religion, gender, age, ancestry, nationality, veteran status, disability, or any other status protected by law.

THIS APPLICATION WILL REMAIN ACTIVE FOR A PERIOD OF TIME NOT TO EXCEED 120 DAYS UPON SUBMISSION.

First Name: * This field is required

Last Name: * This field is required

Street: * This field is required

City: * This field is required

State: * This field is required

Zip: * This field is required

Phone: * This field is required

Social Security Number (Information is required to complete criminal/BMV background checks.) * This field is required

Birthdate *

This field is required

Email:

Please provide the details of your interest. * This field is required

Organization Affiliation

Were you referred by someone? If yes, please provide their name.

Explain volunteer’s interest/purpose and date(s) of involvement:

If driving a motor vehicle is a required duty, do you hold a valid Ohio Driver License?

Yes

Have you been convicted of any crime (after age 18) other than minor traffic violations? *

This field is required

If yes, please explain the details of all convictions (dates, charges, locations, incarceration, etc.):

Do you have any criminal charges pending at present? *

This field is required

If yes, please explain the details:

High School Name & Address * This field is required

Years Completed

9th Grade

10th Grade

11th Grade

12th Grade

High School Diploma * This field is required

College/University Name & Address

Years Completed

1 Year

2 Years

3 Years

4 Years

College/University Degree

Reference #1

This field is required

First Name: * This field is required

Last Name: * This field is required

Phone: * This field is required

Relationship: * This field is required

Years Known: * This field is required

Reference #2

This field is required

First Name: * This field is required

Last Name: * This field is required

Phone: * This field is required

Relationship: * This field is required

Years Known: * This field is required

Reference #3

This field is required

First Name: * This field is required

Last Name: * This field is required

Phone: * This field is required

Relationship: * This field is required

Years Known * This field is required

I understand that submission of the application does not insure acceptance as a volunteer. I understand that if accepted, my service as a volunteer may be discontinued at the sole discretion of the Judge or designee, at any time, with or without notice. I further understand that this agreement is for unpaid, nonemployee, volunteer activities, and as a volunteer, I am not entitled to any compensation or benefits including health insurance, worker’s compensation, unemployment insurance, or any retirement plan. I authorize the investigation of any and all of my background and any other information from whomever the Court deems appropriate or desires, and I also authorize the release of any and all information by whomever the Court deems appropriate or desires, including the Court itself. I release all parties from all liability for any damage that may result from furnishing this information to the Court. Further, I understand that this application and any records kept by the Court regarding my volunteer activities or status may be made available to public access. I understand that the law is protective of juvenile privacy rights, and as a Court volunteer, I must hold all information as confidential, and I must not discuss any child, case, records, etc. within the community beyond the scope of my role with the Court. Further, any release of records of any kind must have the advance, written authorization of the Court. All Court volunteers are to maintain a patient, dignified, and courteous demeanor when interacting with detained youth and Court personnel. To ensure optimum safety and security, volunteers are required to strictly adhere to detention facility policies and the instruction of detention staff while on Court premises. Relationships formed with youth with whom the Court deals in an official capacity are to be kept strictly professional and appropriate, and in accordance with all applicable law, and in compliance with the guidance of the Court, and with the policies of any agency or organization with whom the volunteer may be associated. I certify that the information contained in this application is true and complete to the best of my knowledge, and I understand that any false or misleading information given in this application or subsequent interviews shall be grounds for my rejection or dismissal as a volunteer. I further certify that I have read all of the foregoing, understand the same and do hereby voluntarily agree to all the provisions contained herein. I understand that I am required to abide by all rules and regulations of the Court if accepted as a volunteer. I further understand that this agreement supersedes any and all previous agreements made by any representative of the Court. Following my acceptance and at any time while active as a volunteer, I agree to notify the Richland County Juvenile Court within 24 hours in the event that I am arrested, have charges pending, or have been convicted of any charges other than minor traffic violations.

I agree that any claim or lawsuit relating to my application or employment with the Richland County Common Pleas Court, Juvenile Division, must be filed no more than six (6) months after the date of the employment action that is the subject of the claim or lawsuit. I specifically and voluntarily waive any statute of limitations to the contrary. Further, I hereby irrevocably and unconditionally waive any right I may have to a trial by jury in respect of any litigation relating to my employment with the Court. Please type your full name below to acknowledge your agreement.

Please type your full name below to acknowledge your agreement. * This field is required

App

Richland County Juvenile Justice Center
411 South Diamond Street
Mansfield, OH 44902
Phone: (419) 774-5578
Fax: (419) 774-5555

Hours of Operation:
Monday - Friday 8:00 a.m. - 4:00 p.m.