BUREAU OF JUSTICE ASSISTANCE NATIONAL TRAINING AND TECHNICAL ASSISTANCE CENTER CONSULTANT APPLICATION PACKAGE

Size: px
Start display at page:

Download "BUREAU OF JUSTICE ASSISTANCE NATIONAL TRAINING AND TECHNICAL ASSISTANCE CENTER CONSULTANT APPLICATION PACKAGE"

Transcription

1 BUREAU OF JUSTICE ASSISTANCE NATIONAL TRAINING AND TECHNICAL ASSISTANCE CENTER CONSULTANT APPLICATION PACKAGE Thank you for your interest in becoming a consultant for the Bureau of Justice Assistance (BJA) National Training and Technical Assistance Center (NTTAC). NTTAC is a major source of criminal justice training and technical assistance information and resources, offering specialized assistance on current laws and evolving trends that affect the criminal justice field. BJA s mission is to provide policy leadership and assistance that supports local criminal justice strategies to achieve safe communities. One of BJA s most important functions is to support the work of practitioners in state, local, and tribal justice systems through training and technical assistance (TTA) programs. BJA-sponsored TTA provides direct assistance to develop and implement comprehensive, system-wide strategies for public safety that also improve criminal justice systems. One of the methods employed to make resources available to those who request TTA is to utilize consultant experts in the field. Your specialized knowledge can provide much needed information and assistance to law enforcement officials on a nationwide basis. We are looking for individuals who possess policy-making as well as hands-on experience in the criminal justice field. Applicants must possess a broad and deep knowledge of current literature and what works processes to inform criminal justice policies. All NTTAC consultants have a federally approved labor rate. This rate cannot exceed the maximum rate of $450. This form documents justification for the daily rate that the consultant is requesting. Supporting documentation must be provided and may include wage statements or W-2 forms, contracts or letters of engagement, or other documentation that shows that the consultant has been paid the requested rate in the past. Please fill out the online application in order to be considered as a consultant. The information provided will be used to match consultant areas of expertise with requestor need. Upon submission, your application will be reviewed by NTTAC staff and sent to the Bureau of Justice Assistance for approval. Once approval is received the consultant information will be added to our database pool of consultants. If you have questions or need assistance completing this application please call BJA-TTAC ( ) or nttac@bjatraining.org and an NTTAC staff member can assist you. REQUIRED DOCUMENTS CHECKLIST In order for your application to be considered complete, the following documents must be submitted online in addition to your application. Applications that are not completed within two weeks will be removed from the NTTAC database. Completed Online Application Resume Please submit a maximum of 2 pages for your resume in a PDF/Word document Publications List Please include your most relevant/current publications in a PDF/Word document Sample Work Products Please submit any sample documents, presentations, or curricula of work you have produced Photo (Optional) Please submit a recent photo in a Jpeg format for use with your biography. 1

2 BJA NTTAC CONSULTANT APPLICATION Section I Contact Information Name Prefix: First: Last: Title Occupation Organization Name Address Address (line 2) City State Zip Code Phone Number ( ) Fax Number ( ) Address Website Section II Educational Background Please list all institutes of higher education from which you have earned degrees: Institution Degree Date Earned Area of Concentration Please list licenses and certifications you have obtained within the past two years and currently hold: License/Certification Date Awarded Please list any professional development course you have taken within the past two years: Course Organization Date Completed 2

3 Section III Subject Matter Expertise This section documents areas of advocacy in the criminal justice field in which you have worked. Please check all that apply. ADVOCACY Adjudication Case Management Child Protection/Health Corrections/Jails Counseling Courts/Sentencing/Sanctions/Specialized Problem Solving Criminal Justice Advocacy and Support Years of Crisis Response Domestic Violence Financial Assistance Justice Information Sharing Juvenile/Issues/Delinquency Prevention/Risk Years of Legal Issues Mental Health Reentry/Release Restitution Shelter/Safe House/Transitional Housing Years of Substance Abuse Treatment and Education Years of Transportation Victim Services This section documents the areas of criminal justice and law enforcement in which you have experience. Please check all that apply. CRIMINAL JUSTICE AND LAW ENFORCEMENT Adjudication Administration / Management Arson / Hazardous Materials Asset Forfeiture Bomb/Explosives Detection Child Protection/Health Community Policing Corrections/Jails Counterterrorism/Terrorism Courts Hostage Negotiations Intelligence Interrogation/Interview Techniques Years of Investigations Juvenile-Delinquency K-9 Legal Issues Mental Health Missing and Exploited Children 3

4 Crime Prevention Crisis Management Critical Incident Stress Management Years of Cyber Crime/Computer Crimes D.A.R.E. Death Investigation Domestic Violence Drugs/Narcotics, Funding DUI/DWI Emergency First Responders Ethics / Integrity/Diversity Evidence Collection/Management Explosives Fire Safety Firearms / Weapons Forensics/Photography Gangs Hate/Bias Crimes Multijurisdictional Task Forces Officer Safety and Survival Personal Protective Equipment Port/Cargo Security Property/Violent Crimes Public Information Activities School Safety Security Substance Abuse SWAT/Tactical Technology / Computer Applications Years of Traffic/Accident Training Development Tribal Justice Victimization Witness Support White Collar Crime OTHER: Please describe: Section IV Population Please indicate the different types of populations with which you have had experience working. Racial/Ethnic African American American Indian/Native Alaskan Asian Hispanic Native Hawaiian/Pacific Islander Children (ages birth-12 years) Elderly Females Gangs Homeless Immigrant Incarcerated Juvenile/Youth (ages 13-18) Lesbian/Gay/Transgender Males 4

5 Persons with Disabilities Disabled Veteran Hearing Impaired Mental Retardation Physical Disability Psychiatric Disability Sight Impaired Persons with HIV/AIDS Persons of Faith Buddhist Christian Hindu Jewish Muslim Other Substance Abusers Sex Workers Rural Sex Offenders Urban Victims Witnesses Other Section V Target Audience This section documents the primary audiences with which you have had experience working. Please check all that apply. Administrators Community Based Organizations Years of Corrections Professionals Courts Defense Counsel Educators Emergency Service Providers Faith-Based Organizations Federal Justice General Public Health Care Providers Juvenile Justice Judges Law Enforcement Media Medical/Dental Providers Mental Health Providers Military Legislators Probation/Parole Officers Prosecutors Schools State Agencies Social Workers Substance Abuse Prevention/Treatment Center Tribal Justice 5

6 Universities Victims Advocates Volunteers Other Section VI Training and Technical Assistance Expertise This section documents the types of training and technical assistance that you have had experience providing. Please check all that apply. Accreditation Analyzing training needs Board development Conducting peer reviews Conducting research Community planning Data collection/analysis Delivering messages to the media Delivering onsite/offsite consultation Delivering presentations/ lectures Delivering trainings/conducting workshops Developing customized TTA Developing outreach/education materials Developing written TTA materials/curricula Developing skilled trainers/train the trainer Leadership/management skill building Literature/product review Managing strategic planning Mentoring peers Needs assessment/planning Organizational analysis Organizational development Performance measures development Program design/development Program evaluation Program sustainability Staff recruitment/retention Utilizing social media Volunteer Recruitment/Retention Webinar development/presentation Distance/online learning Fiscal management/funding strategies Grants administration Group facilitation 6

7 Section VII Language Fluency This section documents languages with which you have the ability to read, speak, or write. Please check all that apply. American Sign Language Read Speak Write Moderate Chinese Read Speak Write Moderate English Read Speak Write Moderate French Read Speak Write Moderate German Read Speak Write Moderate Hindi Read Speak Write Moderate Inuit Read Speak Write Moderate Italian Read Speak Write Moderate Japanese Read Speak Write Moderate Russian Read Speak Write Moderate Spanish Read Speak Write Moderate Vietnamese Read Speak Write Moderate Other Read Speak Write Moderate Section VIII Additional Information The following information is voluntary and disclosed at your own discretion. This information is for internal purposes only. Gender: Male Female Race/Ethnicity: African-American (not of Hispanic origin) American Indian/Native Alaskan Asian Native Hawaiian/Pacific Islander Hispanic White (not of Hispanic origin) Other (please describe) Are you a United States citizen? Yes No If no, are you eligible for work in the US? Yes No Do you have a disability or any special needs? Yes No If yes, please describe: Will you need any special accommodations while providing training and technical assistance for BJA NTTAC? Yes No If yes, please describe: 7

8 Please describe your current employment: Contractor Self-Employed (independent consultant) For-Profit Organization Non-Profit Organization Medical Health/Mental Health Federal Government State Government Tribal Government Federal Law Enforcement State Law Enforcement Local Law Enforcement Legal Courts Faith-based Organization Local Government Do you have any geographical areas of preference in which you would like to deliver TTA? Yes No If yes, please describe: Do you have any preferred method of TTA delivery? Yes No If yes, please describe: How did you learn about applying to become a consultant for BJA NTTAC? Choose an item. Section IX References Please fill out the information below with references of individuals who know your ability to perform the work described in this application. These individuals may be colleagues, employers, TTA clients, organizations, or institutions. Name Prefix: First: Last: Title Organization Name Address Address (line 2) City State Zip Code Phone Number ( ) Fax Number ( ) Address Length of Time Known 8

9 Name Prefix: First: Last: Title Organization Name Address Address (line 2) City State Zip Code Phone Number ( ) Fax Number ( ) Address Length of Time Known Name Prefix: First: Last: Title Organization Name Address Address (line 2) City State Zip Code Phone Number ( ) Fax Number ( ) Address Length of Time Known Section X Biography Please give a brief (300 words or less) biographical sketch of yourself including educational background, professional employment, and publications/accomplishments. This will be used in the event that publication materials are needed for TTA. See example below of an appropriate biography. John Smith is a Research Analyst with XYZ Institute. In this role, his primary responsibilities include research and writing on a range of criminal justice issues. He has recently authored a new publication, Trends in Criminal Justice, and is currently developing a trainer s guide for the same work. Mr. Smith also works as the program manager for a Cooperative Agreement with the Department of Health and Human Services. In this capacity, he speaks to regional audiences around the country and assists in the coordination of workshops, webcasts, and technical assistance for youth-serving organizations to implement a gang prevention component into existing programs. A nationally-known expert in the criminal justice field, Mr. Smith is regularly sought out by the national press. His media appearances include Larry King Live, CBS Evening News, ABC Evening News, The New York Times, The Washington Post, The Washington Times, CBS Radio, NBC Radio and National Public Radio. His columns discussing a variety of timely issues routinely appear in newspapers throughout the country. Prior to coming to XYZ Institute in January of 2006, Mr. Smith graduated from the University of Pennsylvania with a Bachelor s Degree in Criminal Justice and Computer Science. He served two years in the Peace Corps following his graduation from college. In 9

10 Jamaica he did marketing for a small cyber center and taught computer and environmental education classes. Upon his return, he developed a computer based gang prevention program for elementary aged children. Mr. Smith is currently pursuing a Master s Degree in Business Administration. Thank you for completing the BJA NTTAC Consultant Application! 10

Victim Information. Other Information. How did you find out about the CVCP? Check the box that applies: Police/Law Enforcement

Victim Information. Other Information. How did you find out about the CVCP? Check the box that applies: Police/Law Enforcement Department of Labor and Industries Crime Victims Compensation Program PO Box 44520 Olympia WA 98504-4520 Email: CrimeVictimsProgramM@LNI.WA.GOV Fax: (360) 902-5333 Crime Victim s Application for Benefits

More information

Children's Bureau Child and Family Services Reviews Consultant Profile Form

Children's Bureau Child and Family Services Reviews Consultant Profile Form Children's Bureau Child and Family Services Reviews Consultant Profile Form Revised April 2008 (Please Type or Print Legibly) Identifying Information First Name Middle Name/Initial Last Name Home Address

More information

VICTIM COMPENSATION APPLICATION

VICTIM COMPENSATION APPLICATION OFFICE OF THE ATTORNEY GENERAL Crime Prevention & Victim Services Crime Victim Compensation Division Post Office Box 220 Jackson, Mississippi 39205-0220 1-800-829-6766 or 601-359-6766 601-576-4445 (FAX)

More information

*****THIS FORM IS NOT A PROTECTIVE ORDER APPLICATION OR A PROTECTIVE ORDER*****

*****THIS FORM IS NOT A PROTECTIVE ORDER APPLICATION OR A PROTECTIVE ORDER***** SHAREN WILSON CRIMINAL DISTRICT ATTORNEY OF TARRANT COUNTY, TEXAS PROTECTIVE ORDER UNIT Family Law Center Phone Number 817-884-1623 200 East Weatherford Street # 3040 Fax Number 817-212-7393 Fort Worth,

More information

*****THIS FORM IS NOT A PROTECTIVE ORDER APPLICATION OR A PROTECTIVE ORDER*****

*****THIS FORM IS NOT A PROTECTIVE ORDER APPLICATION OR A PROTECTIVE ORDER***** SHAREN WILSON CRIMINAL DISTRICT ATTORNEY OF TARRANT COUNTY, TEXAS PROTECTIVE ORDERS Family Law Center Phone Number 817-884-1623 200 East Weatherford Street # 3040 Fax Number 817-212-7393 Fort Worth, Texas

More information

FAQ s for Defense Attorneys Community-Based Domestic Violence Advocates: A Resource for Battered Women Charged with Crimes

FAQ s for Defense Attorneys Community-Based Domestic Violence Advocates: A Resource for Battered Women Charged with Crimes FAQ s for Defense Attorneys Community-Based Domestic Violence Advocates: A Resource for Battered Women Charged with Crimes The content for this article was developed by a group of attorneys and community-based

More information

EMPLOYMENT APPLICATION

EMPLOYMENT APPLICATION SPALDING COUNTY BOARD OF COMMISSIONERS 119 E. Solomon Street, P.O. Box 1087 Griffin, Georgia 30224 www.spaldingcounty.com EMPLOYMENT APPLICATION SPALDING COUNTY ONLY ACCEPTS APPLICATIONS FOR CURRENTLY

More information

Certified Peer Counselor Training Application

Certified Peer Counselor Training Application Certified Peer Counselor Training Application Instructions Please type or print clearly. All sections of the form must be completed for the application to be accepted. These instructions explain how to

More information

Application. Minnesota Crime Victims Reparations Board

Application. Minnesota Crime Victims Reparations Board Application Minnesota Crime Victims Reparations Board The Minnesota Crime Victims Reparations Board provides financial assistance to victims of violent crime and their family members for related expenses

More information

CRIME VICTIM S REPARATION CLAIM FORM INSTRUCTIONS

CRIME VICTIM S REPARATION CLAIM FORM INSTRUCTIONS CRIME VICTIM S REPARATION CLAIM FORM INSTRUCTIONS In order to process your claim for compensation, the following information is needed: 1. The claim for compensation must be thoroughly and accurately completed.

More information

Crime Victim Compensation

Crime Victim Compensation Crime Victim Compensation Eighth Judicial District Crime Victim Compensation 201 LaPorte Avenue Ste 200 Fort Collins CO 80521 970-498-7290 www.larimer.org/da/vicwit/compensation.htm APPLICATION The Victim

More information

The application must include the signature of the victim or of the claimant if the victim is under the age of 18 years old.

The application must include the signature of the victim or of the claimant if the victim is under the age of 18 years old. Denver Crime Victim Compensation Application Check List In order to ensure that your application is processed as quickly as possible, please review the following checklist: The incident must have been

More information

24. How does your disability keep you from working, or cause problems in your ability to maintain work? phone: phone: phone: date(s) date(s) date(s)

24. How does your disability keep you from working, or cause problems in your ability to maintain work? phone: phone: phone: date(s) date(s) date(s) USOR-4 (Rev. 8/04) Utah State Office of Rehabilitation VOCATIONAL REHABILITATION APPLICATION PART I: Tell us about yourself. 1. Social Security Number (Office use only) Case #: 2. Legal Name (Last) (First)

More information

CRIME VICTIM COMPENSATION APPLICATION

CRIME VICTIM COMPENSATION APPLICATION CRIME VICTIM COMPENSATION APPLICATION Weld County District Attorney s Office Kenneth R. Buck-District Attorney Post Office Box 1167 915 Tenth Street Greeley, CO 80632 (970) 356-4010 Fax (970) 336-7224

More information

SUPERIOR COURT OF THE DISTRICT OF COLUMBIA CRIME VICTIMS COMPENSATION PROGRAM 515 Fifth Street, N.W., Suite 109 Washington, D.C.

SUPERIOR COURT OF THE DISTRICT OF COLUMBIA CRIME VICTIMS COMPENSATION PROGRAM 515 Fifth Street, N.W., Suite 109 Washington, D.C. SUPERIOR COURT OF THE DISTRICT OF COLUMBIA CRIME VICTIMS COMPENSATION PROGRAM 515 Fifth Street, N.W., Suite 109 Washington, D.C. 20001 APPLICATION FOR CRIME VICTIMS COMPENSATION DATE RECEIVED: CLAIM NUMBER:

More information

How To Write A Book

How To Write A Book THOMAS B. HEFFELFINGER RESUME Personal Education Office: Best & Flanagan LLP 225 South Sixth Street, Suite 4000 Minneapolis, Minnesota 55402-4690 Office Telephone: (612) 339-7121 Office Fax: (612) 339-5897

More information

Best & Flanagan LLP 225 South Sixth Street, Suite 4000 Minneapolis, Minnesota 55402-4690 Office Telephone: (612) 339-7121 Office Fax: (612) 339-5897

Best & Flanagan LLP 225 South Sixth Street, Suite 4000 Minneapolis, Minnesota 55402-4690 Office Telephone: (612) 339-7121 Office Fax: (612) 339-5897 THOMAS B. HEFFELFINGER RESUME Personal Office: Best & Flanagan LLP 225 South Sixth Street, Suite 4000 Minneapolis, Minnesota 55402-4690 Office Telephone: (612) 339-7121 Office Fax: (612) 339-5897 Education

More information

West Virginia Department of Health and Human Resources. Application for Child Care Services

West Virginia Department of Health and Human Resources. Application for Child Care Services West Virginia Department of Health and Human Resources Application for Child Care Services I. INSTRUCTIONS Please complete this form in order to apply for child care services. Be sure to sign and date

More information

Application for Employment

Application for Employment Application for Employment 1161 Ingleside Road Norfolk, Virginia 23502 Phone: 757-858-8011 Fax: 757-627-4760 www.egglestonservices.org Position*: Site: Full Time Part Time Temporary Seasonal/Camp PERSONAL

More information

Nj Victims of Crime Compensation Office

Nj Victims of Crime Compensation Office Nj Victims of Crime Compensation Office Claim Information and Application Instructions New Jersey has a Crime Victim s Compensation Fund to help with costs related to injuries received in a violent crime.

More information

OFFICE OF THE ATTOR GENERAL ELIGIBILITY REQUIREMENTS

OFFICE OF THE ATTOR GENERAL ELIGIBILITY REQUIREMENTS OFFICE OF THE ATTOR YGENERAL CRIME VICTIM COMPENSATION DIVISION POST OFFICE BOX 22 JACKSON, MS 3925 22 1-8-829-6766 OR 61-359-6766 61-576-4445 (FAX) If you or a family member have been a victim of a violent

More information

Compensation. Financial Assistance. Resources. Office of Attorney General. for Victims of Crime in the Commonwealth of Massachusetts

Compensation. Financial Assistance. Resources. Office of Attorney General. for Victims of Crime in the Commonwealth of Massachusetts Resources If you are a crime victim, you have certain rights under Massachusetts Law, and you are eligible for certain services. For further information about victim rights and victim services, contact

More information

RED BOOK ONLINE INDEX TERM GUIDE

RED BOOK ONLINE INDEX TERM GUIDE RED BOOK ONLINE INDEX TERM GUIDE 1. The 100 most common WHAT (service type) terms Accompaniment 80 Administration 225 Adoption 27 Advocacy 690 Arts And Culture 37 Assessment 193 Camps (Day) 45 Camps (Residential)

More information

Section A Victim/Applicant Information (A separate application must be completed for each victim.)

Section A Victim/Applicant Information (A separate application must be completed for each victim.) Application For Crime Victim Compensation Claim No. Arkansas Crime Victims Reparations Board 323 Center Street, Suite 200 Little Rock, Arkansas 72201 Office of the (501) 682-1020 or 1-800-448-3014 This

More information

COMMUNITY CONTROL OFFICER

COMMUNITY CONTROL OFFICER DELAWARE MUNICIPAL COURT JOB OPPORTUNITY COMMUNITY CONTROL OFFICER Qualifications: Job Summary: Requirements: Salary: The Delaware Municipal Court is seeking applicants for the position of Community-Control

More information

What s Going On to safeguard children and young people from sexual exploitation? : A data monitoring Tool

What s Going On to safeguard children and young people from sexual exploitation? : A data monitoring Tool What s Going On to safeguard children and young people from sexual exploitation? : A data monitoring Tool Introduction In 2009 the government published guidance on Safeguarding children and young people

More information

Los Angeles County Department of Health Services Alcohol and Drug Program Administration

Los Angeles County Department of Health Services Alcohol and Drug Program Administration Los Angeles County Department of Health Services Annual Review of Participants in Alcohol and Drug Programs Contracted by the 2003-04 Fiscal Year Prepared by Research and Evaluation Planning Division Los

More information

Name of victim (last, first, middle) Home telephone Work telephone. Name of claimant (last, first, middle) Home telephone Work telephone

Name of victim (last, first, middle) Home telephone Work telephone. Name of claimant (last, first, middle) Home telephone Work telephone Personal injury compensation application JD-VS-8PI Rev. 12/07 section one - Victim information Name of victim (last, first, middle) Home telephone Work telephone Address cell telephone age City State Zip

More information

Certified Peer Counselor Training Application

Certified Peer Counselor Training Application Certified Peer Counselor Training Application Instructions Please type or print clearly. All sections of the form must be completed for the application to be accepted. These instructions explain how to

More information

SIERRA COLLEGE PART TIME FACULTY APPLICATION 5000 ROCKLIN ROAD ROCKLIN CA 95677

SIERRA COLLEGE PART TIME FACULTY APPLICATION 5000 ROCKLIN ROAD ROCKLIN CA 95677 SIERRA COLLEGE PART TIME FACULTY APPLICATION 5000 ROCKLIN ROAD ROCKLIN CA 95677 An Equal Employment Opportunity/Affirmative Action Employer This application will be used by a committee to select applicants

More information

Application for Certified Peer Specialist (CPS) Training 2016

Application for Certified Peer Specialist (CPS) Training 2016 Application for Certified Peer Specialist (CPS) Training Program For Veterans Philadelphia, PA Dates: April 4-8 & April 11-15, 2016 Application Deadline: March 21, 2016 Cost: $1250.00 Information about

More information

The Many Facets of Social Work

The Many Facets of Social Work The Many Facets of Social Work The scope of social work practice is remarkably wide. Social workers practice not only in the traditional social service agency, but also in elementary schools; in the military;

More information

Technical Report # 15-034. Submitted by: Danna Moore, Ph.D. Arina Gertseva, Ph.D.

Technical Report # 15-034. Submitted by: Danna Moore, Ph.D. Arina Gertseva, Ph.D. CIVIL LEGAL PROBLEMS EXPERIENCED BY VICTIMS OF DOMESTIC VIOLENCE AND SEXUAL ASSAULT IN WASHINGTON STATE Findings from 2014 Civil Legal Needs Study Update Technical Report # 15-034 Submitted by: Danna Moore,

More information

Alaska Natives Combating Substance Abuse and Related Violence Through Self-Healing: A Report for the People

Alaska Natives Combating Substance Abuse and Related Violence Through Self-Healing: A Report for the People Alaska Natives Combating Substance Abuse and Related Violence Through Self-Healing: A Report for the People Appendix A Bristol Bay Women s Conference Draft Recommendations to Stop Violence Recommendations

More information

PROTECTIVE ORDER UNIT QUESTIONNAIRE FANNIN COUNTY CRIMINAL DISTRICT ATTORNEY S OFFICE

PROTECTIVE ORDER UNIT QUESTIONNAIRE FANNIN COUNTY CRIMINAL DISTRICT ATTORNEY S OFFICE PROTECTIVE ORDER UNIT QUESTIONNAIRE FANNIN COUNTY CRIMINAL DISTRICT ATTORNEY S OFFICE HOW TO USE THE QUESTIONNAIRE USE BLACK INK ONLY blue ink and other colors of ink are difficult to read, especially

More information

Ohio Victims of Crime Compensation Program Application for Crime Victim Compensation

Ohio Victims of Crime Compensation Program Application for Crime Victim Compensation Ohio Victims of Crime Compensation Program Application for Crime Victim Compensation Please type or print using blue or black ink After an application has been filed, the law may provide for payment of

More information

Application & Renewal Form

Application & Renewal Form Section A: I want health insurance for: (Check ( ) the category or categories that match your situation.) Myself, my spouse (or other parent of my children) and our children under age 19 who live with

More information

executive summary method findings actions

executive summary method findings actions OHIO JUVENILE JUSTICE NEEDS ASSESSMENT executive summary method findings actions Bob Taft, Governor Maureen O Connor, Lt. Governor Ohio Office of Criminal Justice Services Ohio Department of Youth Services

More information

Application for Graduate Study

Application for Graduate Study Application for Graduate Study Expected Registration Year: Graduate Program: Name: Maiden: Address: City: County: State: Zip: Are you a U.S. Citizen? Yes No Nation of Citizenship: If no: Green Card Degree

More information

The Legal Aid Society. Examining the Veterans Treatment Court Model

The Legal Aid Society. Examining the Veterans Treatment Court Model Testimony of The Legal Aid Society at a public hearing on: Examining the Veterans Treatment Court Model Presented to: The New York City Council Committee on Veterans and Committee on Fire and Criminal

More information

Victim Services Programs. Core Service Definitions

Victim Services Programs. Core Service Definitions Victim Services Programs Core Service Definitions EFFECTIVE MAY 2012 1 P a g e Core Services Overview The Criminal Justice Coordinating Council (CJCC) strives to be a responsible and exemplary steward

More information

Please note: We are accepting applications for 1-4 bedroom apartments only.

Please note: We are accepting applications for 1-4 bedroom apartments only. Page 1 Gardens at SouthBay Preliminary Application 6720 S. Louis Ave, Tampa, FL 33616 PLEASE RETURN APPLICATION MONDAY THURSDAY 9AM 6PM POR FAVOR DE REGRESAR LA APLICACIÓN DE LUNES A JUEVES DE 9AM A 6PM

More information

Project Transformation Oklahoma Application PERSONAL PROFILE

Project Transformation Oklahoma Application PERSONAL PROFILE PERSONAL PROFILE 1. NAME: LAST FIRST MIDDLE 2. AmeriCorps members must be a United States citizen, U.S. National or Lawful Permanent Resident. Are you a U.S. Citizen, national, or lawful permanent resident

More information

FLORIDA STATE APPLICATION (Please Print, Black or Blue Ink Only)

FLORIDA STATE APPLICATION (Please Print, Black or Blue Ink Only) National Association of Community Health Centers, Inc The Florida Community HealthCorps FLORIDA STATE APPLICATION (Please Print, Black or Blue Ink Only) An AmeriCorps State Program of the National Association

More information

APPLICATION FOR CRIME VICTIM COMPENSATION (Please print clearly and complete the entire form)

APPLICATION FOR CRIME VICTIM COMPENSATION (Please print clearly and complete the entire form) Maryland Criminal Injuries Compensation Board (CICB) Department of Public Safety and Correctional Services 6776 Reisterstown Rd, Ste. 206 Baltimore, MD 21215 410-585-3010 1-888-679-9347 (fax) 410-764-3815

More information

Assisting Immigrant Victims of Domestic Violence

Assisting Immigrant Victims of Domestic Violence Assisting Immigrant Victims of Domestic Violence ADVOCATE S GUIDE This project was supported by Grant No. 1997-WT-VX-K006 awarded by the Office on Violence Against Women, U.S. Department of Justice. Points

More information

Federal revenues deposited into the Crime Victims Fund come from the following sources:

Federal revenues deposited into the Crime Victims Fund come from the following sources: Page 1 of 3 OVC HOME MORE OVC FACT SHEETS LIBRARY & MULTIMEDIA Site Search Crime Victims Fund Text size: A A The Crime Victims Fund (the Fund), established by the Victims of Crime Act of 1984 (VOCA), is

More information

THOMAS B. HEFFELFINGER

THOMAS B. HEFFELFINGER THOMAS B. HEFFELFINGER RESUME Personal Education Office: Best & Flanagan LLP 60 South Sixth Street, Suite 2700 Minneapolis, Minnesota 55402-4690 Office Telephone: (612) 339-7121 Office Fax: (612) 339-5897

More information

Application for Vocational Rehabilitation Services

Application for Vocational Rehabilitation Services Strong Families Make a Strong Kansas Application for Vocational Rehabilitation Services Is Vocational Rehabilitation the right program for you? Some brief information about the Vocational Rehabilitation

More information

CRIME VICTIM COMPENSATION FUND APPLICATION

CRIME VICTIM COMPENSATION FUND APPLICATION Office Use Only Claim No. Crime Victim Compensation Board Office of the District Attorney, 20 th Judicial District 1035 Kimbark Street, Longmont, CO 80501 Phone (303) 682-6801 Fax (303) 682-6711 CRIME

More information

CRIMINAL LAW AND VICTIMS RIGHTS

CRIMINAL LAW AND VICTIMS RIGHTS Chapter Five CRIMINAL LAW AND VICTIMS RIGHTS In a criminal case, a prosecuting attorney (working for the city, state, or federal government) decides if charges should be brought against the perpetrator.

More information

CITY OF COEUR D'ALENE

CITY OF COEUR D'ALENE CITY OF COEUR D'ALENE HUMAN RESOURCES City Hall, 710 E. Mullan Avenue Cœur d Alene, Idaho 83816-3964 EXAM ANNOUNCEMENT FOR POLICE OFFICER Apply by August 15, 2014 for the September 8-12, 2014 Testing Process

More information

Victims Compensation Assistance Program Short Form

Victims Compensation Assistance Program Short Form Pennsylvania Commission on Crime and Delinquency Office of Victims Services Victims Compensation Assistance Program Mailing Address: Street Address: Phone and Fax Numbers: P.O. Box 1167 3101 North Front

More information

DELAWARE COUNTY TREATMENT COURT APPLICATION

DELAWARE COUNTY TREATMENT COURT APPLICATION DELAWARE COUNTY TREATMENT COURT APPLICATION Please read each question carefully before answering. Failure to complete this form accurately will delay the processing of your application. False or misleading

More information

CORRELATES AND COSTS

CORRELATES AND COSTS ANOTHER LOOK AT MENTAL ILLNESS AND CRIMINAL JUSTICE INVOLVEMENT IN TEXAS: CORRELATES AND COSTS Decision Support Unit Mental Health and Substance Abuse Services Another Look at Mental Illness and Criminal

More information

How To Participate In A Drug Court

How To Participate In A Drug Court Program Handbook Cabell County Drug Court SCA Treatment Court Form 200 SR DCT Page 1 of 9 What is Drug Court? West Virginia s Cabell County Drug Court is a collaborative effort of legal, mental health,

More information

How To Fund A Mental Health Court

How To Fund A Mental Health Court Mental Health Courts: A New Tool By Stephanie Yu, Fiscal Analyst For fiscal year (FY) 2008-09, appropriations for the Judiciary and the Department of Community Health (DCH) include funding for a mental

More information

New Horizons Regional Education Centers (C&T) Pacing Guide

New Horizons Regional Education Centers (C&T) Pacing Guide New Horizons Regional Education Centers (C&T) 1 st /Marking Period Course Introduction/ Introduction to New Horizons Handout & Lecture Safety and Safe Practices TDI8702-04.001; TDI8702-04.002; TDI8702-04.003

More information

Rush Center Statewide LGBT Community Survey Results Prepared for Georgia Equality and The Health initiative by the Shapiro Group

Rush Center Statewide LGBT Community Survey Results Prepared for Georgia Equality and The Health initiative by the Shapiro Group Rush Center Statewide LGBT Community Survey Results Prepared for Georgia Equality and The Health initiative by the Shapiro Group In an effort to better understand the needs of gay, lesbian, bisexual and

More information

Application for Employment

Application for Employment Human Resources 2405 East College Way Mount Vernon, WA 98273-5899 Job Line 360-416-7800 Fax 360-416-7878 E-mail: employ@skagit.edu Website: www.skagit.edu Application for Employment Skagit Valley College

More information

Pages 1 of 8 Employment Application - Tennessee

Pages 1 of 8 Employment Application - Tennessee Page 1 of 8 Employment Application Tennessee College of Applied Technology Position Applying For: Personal Information: First Name: Middle Name: Last Name: Maiden Name (If applicable): Address: City: State

More information

Unpaid Student Internship Program

Unpaid Student Internship Program Unpaid Student Internship Program Executive Office of the President Office of National Drug Control Policy The Office of National Drug Control Policy (ONDCP) is a component of the Executive Office of the

More information

Evidence Checklist FOR IMMIGRANT VICTIMS APPLYING FOR THE CRIME VICTIM VISA (U VISA) 1

Evidence Checklist FOR IMMIGRANT VICTIMS APPLYING FOR THE CRIME VICTIM VISA (U VISA) 1 Evidence Checklist FOR IMMIGRANT VICTIMS APPLYING FOR THE CRIME VICTIM VISA (U VISA) 1 This is a comprehensive list. In most cases, these documents are not mandatory. However, the more documentation available,

More information

Postgraduate Certificate FAQs:

Postgraduate Certificate FAQs: Postgraduate Certificate FAQs: 1) What is Forensic Psychology? Forensic Psychology is the application of psychological insights, concepts and skills to the understanding and functioning of the legal and

More information

MIDLAND COLLEGE HUMAN RESOURCES

MIDLAND COLLEGE HUMAN RESOURCES MIDLAND COLLEGE HUMAN RESOURCES 3600 N. Garfield. Midland, TX 79705-6397 Telephone: (432) 685-4532 Fax: (432) 685-6480 Website: www.midland.edu Equal Employment Opportunity Policy: Midland College declares

More information

Veterans Health Administration Fact Sheet

Veterans Health Administration Fact Sheet Veterans Health Administration Fact Sheet Project CHALENG - Community Homelessness Assessment, Local Education and Networking Groups Background Project CHALENG (Community Homelessness Assessment, Local

More information

Mildred Colodny Diversity Scholarship for Graduate Study in Historic Preservation Administered by the National Trust for Historic Preservation

Mildred Colodny Diversity Scholarship for Graduate Study in Historic Preservation Administered by the National Trust for Historic Preservation Mildred Colodny Diversity Scholarship for Graduate Study in Historic Preservation Administered by the National Trust for Historic Preservation Thank you for your interest in the Mildred Colodny Scholarship!

More information

PLEASE COMPLETE AND RETURN

PLEASE COMPLETE AND RETURN PLEASE COMPLETE AND RETURN Voluntary Care Network Application Name of Client (Last) (First) (Middle Initial) Street Address Telephone (home) City State Zip Telephone (alternate) Date of Birth US Citizen

More information

Disc ver. College of Education, Health, & Behavioral Sciences. utm.edu/cehbs

Disc ver. College of Education, Health, & Behavioral Sciences. utm.edu/cehbs the university of tennessee at martin Disc ver UT Martin College of Education, Health, & Behavioral Sciences utm.edu/cehbs Disc ver the possibilities I want to be an educator. Tamias Johnson, Trenton,

More information

Compensation for Crime Victims

Compensation for Crime Victims Compensation for Crime Victims Compensation for Crime Victims Every state in the country operates a program to help pay for some of the expenses resulting from crimes involving violence or abuse. Victims

More information

FINGERPRINT BACKGROUND CHECK

FINGERPRINT BACKGROUND CHECK APPLICATION FOR LICENSURE PHARMACY TECHNICIAN (Non-Renewable: Expires the second June 30 from the date of issuance) OR CERTIFIED OREGON PHARMACY TECHNICIAN (Renewable: Expires September 30 th Annually)

More information

ASPIRA Management Information System OJJDP General Intake Information

ASPIRA Management Information System OJJDP General Intake Information ASPIRA Management Information System OJJDP General Intake Information Name: First Name Middle Name Last Name Nick Name Birth Date: (month/day/year) Address: Street Name Apt. # City State Zip Code Supplemental

More information

Gina Maisto Smith. 215.981.4490 Direct 215.981.4750 Fax smithgm@pepperlaw.com

Gina Maisto Smith. 215.981.4490 Direct 215.981.4750 Fax smithgm@pepperlaw.com Gina Maisto Smith Gina Maisto Smith is a partner in the White Collar Litigation and Investigations Practice Group of Pepper Hamilton LLP, resident in the Philadelphia office. Ms. Smith chairs a national

More information

Volunteer Intern/Clerk Applications. Academic Status. Undergrad Graduate Student Law Student (1L) (2L) (3L) (Circle One) Application Term

Volunteer Intern/Clerk Applications. Academic Status. Undergrad Graduate Student Law Student (1L) (2L) (3L) (Circle One) Application Term OFFICE OF THE STATE S ATTORNEY COOK COUNTY, ILLINOIS ANITA ALVAREZ 69 W. Washington, Suite 3200 STATE S ATTORNEY Chicago, Illinois 60602 Volunteer Intern/Clerk Applications Academic Status Undergrad Graduate

More information

Institute for International Criminal Investigations. Dear Colleagues,

Institute for International Criminal Investigations. Dear Colleagues, Institute for International Criminal Investigations Dear Colleagues, The purpose of this call for nominations is to cordially invite you to nominate experts for the Justice Rapid Response (JRR) training

More information

Part I Improvements to Existing Programs

Part I Improvements to Existing Programs Section-by-Section Analysis of the Second Chance Act: Sec. 1. Short Title. Part I Improvements to Existing Programs This section names the short title of the act as the Second Chance Act of 2007: Community

More information

Application for Employment

Application for Employment ANGELA B. COREY ST AT E A TT ORNEY STATE ATTORNEY Fourth Judicial Circuit of Florida Ed Austin Building 311 West Monroe Street Jacksonville, Florida 32202-4242 Tel: (904) 255-2500 Fax: (904) 255-2942 Application

More information

SPECIAL OPTIONS SERVICES PROGRAM UNITED STATES PRETRIAL SERVICES AGENCY EASTERN DISTRICT OF NEW YORK

SPECIAL OPTIONS SERVICES PROGRAM UNITED STATES PRETRIAL SERVICES AGENCY EASTERN DISTRICT OF NEW YORK SPECIAL OPTIONS SERVICES PROGRAM UNITED STATES PRETRIAL SERVICES AGENCY EASTERN DISTRICT OF NEW YORK February 4, 2013 1 I. Introduction The Special Options Services (SOS) Program was established in the

More information

How To Find Out What Your Facility Offers

How To Find Out What Your Facility Offers U.S. Department of Health and Human Services FORM APPROVED: OMB No. 0930-0106 APPROVAL EXPIRES: 01/31/2016 See OMB burden statement on last page National Survey of Substance Abuse Treatment Services (N-SSATS)

More information

INSTRUCTIONS FOR COMPLETING THE U VISA CERTIFICATION FORM

INSTRUCTIONS FOR COMPLETING THE U VISA CERTIFICATION FORM INSTRUCTIONS FOR COMPLETING THE U VISA CERTIFICATION FORM Overview of the U Visa In October 2000, Congress passed the Victims of Trafficking and Violence Protection Act (the Act). As part of this Act,

More information

STATE OF OREGON - OREGON YOUTH AUTHORITY EMPLOYMENT APPLICATION PERSONAL INFORMATION PREFERENCES EDUCATION COLLEGE/UNIVERSITY EDUCATION

STATE OF OREGON - OREGON YOUTH AUTHORITY EMPLOYMENT APPLICATION PERSONAL INFORMATION PREFERENCES EDUCATION COLLEGE/UNIVERSITY EDUCATION STATE OF OREGON - OREGON YOUTH AUTHORITY EMPLOYMENT APPLICATION State of Oregon Website: http://www.oregonjobs.org For instructions on where to submit your application please see the Description section

More information

SURVIVOR BENEFITS APPLICATION JD-VS-8SB 10/12 SECTION 1 - VICTIM INFORMATION SECTION 2 - CLAIMANT INFORMATION

SURVIVOR BENEFITS APPLICATION JD-VS-8SB 10/12 SECTION 1 - VICTIM INFORMATION SECTION 2 - CLAIMANT INFORMATION SURVIVOR BENEFITS APPLICATION JD-VS-8SB 10/12 We understand that this is a very difficult time for you and your family. We are here to help. If you have any questions about filling out this application

More information

What can I do with a SOCIAL WORK degree?

What can I do with a SOCIAL WORK degree? PUBLIC WELFARE Administration and Planning Program Evaluation Public welfare agencies Private social service agencies including: o Department of Human Services o Department of Education o Housing Services

More information

Master of Social Work Degree Program 8600 University Boulevard Evansville, IN 47712 http://www.usi.edu/msw (812) 464-1843

Master of Social Work Degree Program 8600 University Boulevard Evansville, IN 47712 http://www.usi.edu/msw (812) 464-1843 Master of Social Work Degree Program 8600 University Boulevard Evansville, IN 47712 http://www.usi.edu/msw (812) 464-1843 MSW ADMISSION APPLICATION Advance Standing (BSW) 1 Application Deadline: February

More information

Office of the Attorney General Attn: Personnel The Capitol - PL01 Tallahassee, FL 32399-1050

Office of the Attorney General Attn: Personnel The Capitol - PL01 Tallahassee, FL 32399-1050 A State of Florida Job Application Form is contained on the next four pages. You may print the form, complete the information and mail to the Office of the Attorney General. Please include the position

More information

A Guide to Special Sessions & Diversionary Programs in Connecticut. Superior Court Criminal Division

A Guide to Special Sessions & Diversionary Programs in Connecticut. Superior Court Criminal Division A Guide to Special Sessions & Diversionary Programs in Connecticut Superior Court Criminal Division The Judicial Branch of the State of Connecticut complies with the Americans with Disabilities Act (ADA).

More information

Service Cancellations For all Perkins Loans

Service Cancellations For all Perkins Loans Service Cancellations For all Perkins Loans Note: With the exception of cancellations for Head Start, military (prior to 8/14/08) and volunteer service, the cancellation rate per completed academic year

More information

FIREFIGHTER/PARAMEDIC EMPLOYMENT APPLICATION (Please Print)

FIREFIGHTER/PARAMEDIC EMPLOYMENT APPLICATION (Please Print) FIREFIGHTER/PARAMEDIC EMPLOYMENT APPLICATION (Please Print) FOR OFFICE USE ONLY CITY OF SPRINGFIELD, OHIO PERSONNEL DEPARTMENT 76 EAST HIGH STREET SPRINGFIELD, OHIO 45502 INSTRUCTIONS: Please fill out

More information

Claim Form. Before you fill out this application, please read the information below. Before you complete this application:

Claim Form. Before you fill out this application, please read the information below. Before you complete this application: Claim Form Before you fill out this application, please read the information below. You may qualify to receive payment if: Before you complete this application: The victim suffered physical injury or was

More information

VITA. Michael C. Teague, Ph. D.

VITA. Michael C. Teague, Ph. D. VITA Michael C. Teague, Ph. D. University: Ph. D., Psychology Department of Psychology North Carolina State University M.A., Clinical Psychology University of North Carolina - Greensboro B.A., Psychology

More information

The President. Part III. Monday, December 16, 2002

The President. Part III. Monday, December 16, 2002 Monday, December 16, 2002 Part III The President Executive Order 13279 Equal Protection of the Laws for Faith-Based and Community Organizations Executive Order 13280 Responsibilities of the Department

More information

Seeking Protection from Domestic Violence in New York s. Information for Immigrant Victims with Limited English Proficiency

Seeking Protection from Domestic Violence in New York s. Information for Immigrant Victims with Limited English Proficiency Seeking Protection from Domestic Violence in New York s Family Court: Information for Immigrant Victims with Limited English Proficiency What is domestic violence? If your current or former intimate partner

More information

INVENTORY OF SERVICES AND FUNDING SOURCES FOR PROGRAMS DESIGNED TO PREVENT VIOLENCE AGAINST WOMEN

INVENTORY OF SERVICES AND FUNDING SOURCES FOR PROGRAMS DESIGNED TO PREVENT VIOLENCE AGAINST WOMEN OMB #: 0920-375 Expires: 9/30/96 INVENTORY OF SERVICES AND FUNDING SOURCES FOR PROGRAMS DESIGNED TO PREVENT VIOLENCE AGAINST WOMEN Conducted by Westat, Inc. for Centers for Disease Control and Prevention

More information

Claim Form. Before you fill out this application, please read the information below. You may qualify for payment if:

Claim Form. Before you fill out this application, please read the information below. You may qualify for payment if: Claim Form Before you fill out this application, please read the information below. This claim form should be submitted within one year of the crime. Please include a letter explaining the delay, if more

More information

9 TH Judicial District CRIME VICTIM COMPENSATION FUND 109 Eighth Street, Suite 308 Glenwood Springs, Colorado 81601 (970) 945-8635

9 TH Judicial District CRIME VICTIM COMPENSATION FUND 109 Eighth Street, Suite 308 Glenwood Springs, Colorado 81601 (970) 945-8635 9 TH Judicial District CRIME VICTIM COMPENSATION FUND 109 Eighth Street, Suite 308 Glenwood Springs, Colorado 81601 (970) 945-8635 The 9 th Judicial District Crime Victim Compensation Board can provide

More information

Massachusetts Application for Health and Dental Coverage and Help Paying Costs

Massachusetts Application for Health and Dental Coverage and Help Paying Costs Massachusetts Application for Health and Dental Coverage and Help Paying Costs THINGS TO KNOW HOW TO APPLY Use this application to see what coverage choices you may qualify for. Who can use this application?

More information

POLICE. Patrol Bureau

POLICE. Patrol Bureau POLICE MISSION Working with our diverse communities to safeguard the lives and property of the people we serve, to reduce the incidence and fear of crime, and to enhance public safety. BUSINESS LINES The

More information

GENERAL APPLICATION FOR PENNSYLVANIA CERTIFICATE FORM PDE 338 G (Refer to instructions included with this two page form)

GENERAL APPLICATION FOR PENNSYLVANIA CERTIFICATE FORM PDE 338 G (Refer to instructions included with this two page form) GENERAL APPLICATION FOR PENNSYLVANIA CERTIFICATE FORM PDE 338 G (Refer to instructions included with this two page form) PDE USE ONLY CONTROL NO. APPLICANTS: Please note the following information in regard

More information

Application for bail with electronic monitoring. Section 7(5) Bail Act 2000....[full name]..[address].[occupation] Applicant...

Application for bail with electronic monitoring. Section 7(5) Bail Act 2000....[full name]..[address].[occupation] Applicant... Application for bail with electronic monitoring Section 7(5) Bail Act 2000 In the District / High Court at:...........[full name]..[address].[occupation] Applicant This document is filed by: [name and

More information

RHODE ISLAND COMMISSION FOR HUMAN RIGHTS REFERRAL LIST (Revised July 2012)

RHODE ISLAND COMMISSION FOR HUMAN RIGHTS REFERRAL LIST (Revised July 2012) RHODE ISLAND COMMISSION FOR HUMAN RIGHTS REFERRAL LIST (Revised July 2012) **ALL CALLERS ALSO MAY BE REFERRED TO THE STATE S STATEWIDE REFERRAL SERVICE: DIAL 2-1-1 ACLU (American Civil Liberties Union)

More information