SECURITY CLEARANCE APPLICATION

GED              AA              BIBLE STUDY               PROGRAMS              COUNSELING

KITCHEN                   MEDICAL                 OTHER:__________________________

(Circle One)

Please Complete & Return To LCDC Administrative

Office 72 Hours Prior To Required Admittance Date

Name

 

Date of Application:

Home Address (include City, State & Zip):

 

 

Employment Info: (include Place of Employment, Address, City, State & Zip)

 

 

Home Phone:

Work Phone:

Cell Phone:

Have you ever been convicted of a Felony?

YES (           ) or  NO (           )

 

Supporting Documentation: MUST RETURN ALL 3 REQUESTED DOCUMENTS

Copy of Current Drivers License and/or State Issued Identification Card

Records Check from Lea County Sheriff’s Office or Hobbs Police Dept.

Signed Security Guidelines for Contract Staff and Volunteers (Attached)

 

 

Application Complete: ________________________________ Date:  ________________

                                          Pat Rice, Business Manager 

 

Warden Approval: __________________________________  Date: _________________

**Original Must Be Returned To The Business Manager’s Office**

 

 

SECURITY GUIDELINES FOR

CONTRACT STAFF AND VOLUNTEERS

_______

I understand that I must wear an ID badge each time I enter the secured area (approved Company ID Badge or LCDC Visitor Badge).

_______

I understand that Lea County is not responsible for any accident or injury to me as a result of my choice to enter the secured area.

_______

I understand that inmates are not to be left unattended at any time.

_______

I understand that I am not allowed to bring anything in the secured area for inmates.

_______

I understand that items such as (but not limited to) cell phones, alcohol products of any kind, tobacco products, narcotics, prescription medication, purses, briefcases, lunchboxes, ink pens, money, lighters, matches, CD’s or DVD’s are not allowed into the secured area.

_______

I understand that I am not to advise inmates on any aspect of their case.

_______

I understand that I will not discuss any inmate with anyone on the outside; that I will not contact anyone (in written form, phone call or personal visit) on behalf of any inmate.

_______

I understand I must restrict my movement while inside the secured area; I will go to my duty station and stay until it is time for me to leave the secured area.

(example:  come in to work, leave and return from lunch, leave work)

_______

I understand that all doors must be secured (office doors, classroom doors, etc)

_______

I understand that if I have any association/relationship with any inmate currently or previously incarcerated in LCDC I will notify LCDC in writing BEFORE I enter into the secured area.

_______

I understand that if I violate any security clearance (including – but not limited to the above) my security clearance will be revoked and I will not be allowed into the secured area.

 

____________________________                                                    __________________

Signature                                                                                             Date

**Original Must Be Returned To The Business Manager’s Office**