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Volunteers in Policing Application

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This form has been modified since it was saved. Please review all fields before submitting.

Steps

1. Personal Information This section is complete This section is incomplete
2. Authorizations and Disclosures This section is complete This section is incomplete
3. Availability This section is complete This section is incomplete
4. Tell us more about you... This section is complete This section is incomplete
5. College Internship This section is complete This section is incomplete
6. Education This section is complete This section is incomplete
7. Volunteer History This section is complete This section is incomplete
8. Employment History This section is complete This section is incomplete
9. Submit This section is complete This section is incomplete

Personal Information

First Name*
Middle Name*
Last Name*
Street Address*
City*
State Name*
ZIP*
Email*
Phone*
Continue

Authorizations and Disclosures

Are you 18 years of age or older?*
1. Yes
2. No
Have you ever been convicted of a criminal act?*
1. Yes
2. No
Are you aware a background investigation, including criminal history and extensive employment/social reference checks will be completed if you move forward in the application process?*
1. Yes
2. No
Do you acknowledge, and agree to comply with the City of Eugene's Drug-Free Policy?*
1. Yes
2. No
Are you currently a City of Eugene employee?*
1. Yes
2. No
Continue |Go Back

Availability

How many hours are you able to commit to volunteering each week?*
How long can you commit to volunteering?*
Please write in hours you are available each day of the week
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Continue |Go Back

Tell us more about you...

Names of any City of Eugene employees you are related to or with whom you live, and their relationship to you*
Please provide a brief statement explaining why you are interested in volunteering for the Eugene Police Department.*
Can you operate a computer?*
Typing Speed (WPM)*
Which software programs can you operate proficiently?*
1. Microsoft Word
2. Microsoft Excel
3. Microsoft Access
1. Microsoft Publisher
2. Microsoft PowerPoint
3. Other
How did you learn about the VIP Program?*
1. City of Eugene Employee
2. EPD Volunteer
3. Flyer
4. Friend
5. Internet
6. Radio
1. Register Guard
2. School
3. TV Coverage
4. Volunteer Booth
5. Other
If you have any special skills/talents to offer, please select each relevant area:*
1. Crime Analysis
2. Customer Service/Reception
3. Data Entry/Typing
4. Event Planning
5. Filing
6. Fundraising
1. Grant Writing
2. Inventory
3. Photography
4. Project Management
5. Proofreading/Editing
6. Public Relations/Publicity
1. Recruiting
2. Social Media
3. Vehicle Maintenance
4. Volunteer Management
5. Writer (newsletter articles)
6. Other
Volunteer Opportunities*
1. Animal Services Program
2. Cold Case Squad (law enforcement retirees only)
3. Crime Prevention Unit
4. Evidence Control Unit
5. Forensic Evidence Unit
6. Huckleberry Patrol (graffiti abatement)
7. Image Retrieval Team
8. Photographer
9. Police Chaplain
1. Public Information Office
2. Quartermaster
3. Records Section
4. Seniors on Patrol Team (retirees only)
5. Squad Car Maintenance Team
6. Subpoena Service Team
7. Volunteers in Policing Administration
8. Other
Seniors on Patrol
SOP Self-Screening Questionnaire
Please click the above link and complete the Self-Screening Questionnaire if you are interested in joining the Seniors on Patrol Team
Squad Car Maintenance Team
SCMT Self-Screening Questionnaire
Please click the above link and complete the Self-Screening Questionnaire if you are interested in joining the Squad Car Maintenance Team
Other areas of volunteer interest:
Do you speak a language other than English fluently?*
1. Yes
2. No
Which language(s)?*
Continue |Go Back

College Internship

Are you applying to earn college credit through volunteering?*
1. Yes
2. No
If yes (leave blank if no):
Name of college
Program
Name of internship/practicum advisor
Phone number of advisor
How many hours per week are required?
How many hours total are required?
When do you need to start?
When do you need to start?
When do you need to finish?
When do you need to finish?
Continue |Go Back

Education

Last grade completed?*
1. 1
2. 2
3. 3
4. 4
5. 5
1. 6
2. 7
3. 8
4. 9
5. 10
1. 11
2. 12
3. 13
4. 14
5. 15
1. 16
2. 17
3. 18
4. 19
5. 20
Do you have a high school diploma or equivalency?*
1. Yes
2. No
School
List all schools attended beyond high school and their location
School 1
School
Location
Credits completed
Type of degree earned
Course of study/major
School 2
School
Location
Credits completed
Type of degree earned
Course of study/major
School 3
School
Location
Credits completed
Type of degree earned
Course of study/major
School 4
School
Location
Credits completed
Type of degree earned
Course of study/major
Continue |Go Back

Volunteer History

Do you have any current or former volunteer experience (including community volunteering, internships, cooperative work experience, practicums or any other unpaid work experience?)*
Agency 1
Agency
Duties
Years of Service
Years of Service Start Date
—
Years of Service End Date
Agency 2
Agency
Duties
Years of Service
Years of Service Start Date
—
Years of Service End Date
Agency 3
Agency
Duties
Years of Service
Years of Service Start Date
—
Years of Service End Date
Continue |Go Back

Employment History

Are you retired?*
1. Yes
2. No
If yes, occupation you retired from:
Are you currently employed?*
1. Yes
2. No
Are you currently seeking employment?*
1. Yes
2. No
Please document your most recent employment below (required even if submitting a resume). Do not leave this section blank unless you have no previous employment.
Employer 1
Supervisor's Name
City
State Name
ZIP
Job Title
Employer Phone Number
Hours
1. Part-time
2. Full-time
Reason for Leaving
Dates of Employment
Dates of Employment Start Date
—
Dates of Employment End Date
Currently employed here?
1. Yes
2. No
Employer 2
Supervisor's Name
City
State Name
ZIP
Job Title
Employer Phone
Hours
1. Part-time
2. Full-time
Reason for Leaving
Dates of Employment
Dates of Employment Start Date
—
Dates of Employment End Date
Currently employed here?
1. Yes
2. No
Employer 3
Supervisor's Name
City
State Name
ZIP
Job Title
Employer Phone
Hours
1. Part-time
2. Full-time
Reason for Leaving
Dates of Employment
Dates of Employment Start Date
—
Dates of Employment End Date
Currently employed here?
1. Yes
2. No
Continue |Go Back

Submit

Is there any additional information you would like to provide?
Although not required, we encourage you to submit a cover letter and resume along with your application.
Cover Letter
Resume
Electronic Signature
The information in my application for volunteer service was freely given and is, to the best of my knowledge, true and complete. I understand that any false statements, misleading answers, or any false information on this application or given during the volunteer selection process will be sufficient grounds for elimination from consideration or immediate dismissal at any time.
Name (First and Last)*
Electronic Signature*
1. Sign
By checking this box, I am providing an electronic signature.

Leave This Blank:

1. Receive an email copy of this form.
Email address

This field is not part of the form submission.
Submit | Go Back

* indicates a required field

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