Level I Volunteer Application/Training

• Date: 2025-02
• Legal Form Number: BP-A1070
• Year: 2025
• Section: Federal Bureau of Prisons

Level I Volunteer Application/TrainingBP-A1070

FEB 25

U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS

Thank you for offering your services as a volunteer within the Federal Bureau of Prisons. Please complete the

following questions, clearly print or type your answers.

Institution:

Department:

Date:

Name (Last, First, Middle Initial):

Email Address:

Cell Phone Number:

Work Phone Number:

Emergency Contact:

Name:

Home Phone Number:

Cell Phone Number:

Address:

Do you currently know or have you ever known anyone incarcerated in the Bureau of Prisons ? If so, provide the following

information:

Name of Inmate:

Inmate Number:

Dates of Incarceration:

Relationship:

Institution:

Have you ever endorsed, practiced or use language that will support violence, terrorism, discriminate against others or exclude

others based upon race, color, religion, sex, or national origin? Yes No

This portion must be signed in the presence of the Bureau of Prisons program manager.

Acknowledgement of Training

I am entering the institution as a Level I volunteer (four d ays or less per year). I affirm the Program Manager, of the department I

am providing services for, advised me of conduct, safety and security issues, and general instructions of being in a correctional

setting, and on my responsibilities under the Federal Bureau o f Prisons’sexual abuse and sexual harassment prevention,

detection, reporting, and response policies and proced ures.

I am aware and understand the Federal Bureau of Prisons zero tolerance polic y on sexual abuse and sexual harassment. I have

been instructed and understand how to report incidents of sexual abuse and sexual harassment.

Volunteer’s

Printed Name:

Volunteer’s Signature:

Organization: Date:

Program Manager Signature: Date: Time:

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