Please complete this application form if you are interested in obtaining clearance for access into one of the Multnomah County Sheriff's Office jail facilities. Once you complete this form, click the submit button at the bottom.


Name


Current Employer & Direct Supervisor


Service(s) Provided

Please describe the service(s) you will provide:



Type of Access

Please note the type of access you are requesting:

Phone Access Only: Provides a calling code allowing incoming calls directly to offender.


Non-Contact Visiting Room: Separated from the offender via glass and conversing over a phone. With or without the ability to pass paper documents between parties.


Contact Visiting Room: No glass barrier between offender. Sitting together with direct communication.


Jail-side Access: Escort into secure facility.

Includes Medical Clinic areas.



Schedule

Please describe any scheduling needs:



Special Considerations

Please list any materials, devices, or MCSO resources needed to complete your work:



Acknowledgement Statement

By checking this box you agree to the following:


I understand and agree that submitting this application form does not automatically grant access to a Multnomah County Sheriff's Office jail facility.

I hereby swear or affirm that there are no willful misrepresentations, omissions, or falsifications of the preceding statements.


I understand that misrepresentation, falsifications, or omissions of facts in any documents I submit or statements I make as a part of this process, is cause for rejection of my application and/or termination of my Multnomah County Sheriff’s Office access.