Umatilla County Sheriff s Office 4700 NW Pioneer Place Pendleton, OR 97801 (541) 966-3650 Search and Rescue Unit Volunteer Application so others may live. The Umatilla County Sheriff s Office Search and Rescue Unit accepts volunteer applications from all qualified individuals, without unlawful regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, veteran s status, or any other status protected by applicable federal, Oregon, or local law. All applicants must consent to a criminal history records and background check. Please Print or Type PERSONAL INFORMATION Last Name: First Name: Middle Name: Mailing Address: City: State: Zip Code: Date of Birth: Driver s License or State ID #: Current Age: Social Security Number (required for background Email Address: Are you 18 years of age or older? Yes No Do you have a valid state driver license? Yes No Have you ever been convicted of a crime? Yes No If Yes please explain below: EDUCATION What is your highest level of education? High School Diploma/GED Some College Associate s Degree Bachelor s Degree Graduate Degree Technical College Page 1
COLLEGES/UNIVERSITIES School Major Degree Earned/Year MILITARY Are you a veteran of or currently in the armed services? Yes No If Yes please answer below: Branch: If a veteran did you receive an honorable discharge? Yes No Please list any military experience or training that would enhance your search and rescue ability: EMPLOYMENT HISTORY Please list your current or most recent job first, for up to ten years of employment. You may add an attachment if you need more blocks. You may substitute a Resume in place of employment History. Please put See Resume in the first Work History block if doing so. EMPLOYER #1 Page 2
EMPLOYER #2 EMPLOYER #3 Page 3
REFERENCES List the name, address and phone number of three references who are not related to you and who are not previous employers: 1. 2. 3. SEARCH AND RESCUE EXPERIENCE List any Search and Rescue experience, including the agency with which you were affiliated, and any certifications you hold: When would you most likely be available for search and rescue missions and activities? (Days, nights, weekdays, weekends, etc.) Check off any of the following skills you possess: Map and Compass Off Road Motorcycle Backpacking Tracking ATV Horse Hiking First Aid Boat Operator Mtn. Climbing CPR Pilot Snowshoeing Radio Swimmer Cross Country Skiing Diving Computer Skills List any foreign languages you speak: Do you have any physical or medical conditions that would affect your ability to spend long periods of time on your feet in mountainous terrain during a ground search? If Yes please explain below: Yes No List any personally owned equipment that you would be willing to use during a search and rescue mission: May we call you at work for unit activations or other SAR matters? Yes No Page 4
MISCELLANEOUS List any other experience, skills or personal attributes you think might enhance your ability to participate in search and rescue operations: UNDERSTANDING, ASSURANCES AND AUTHORIZATIONS (Read Carefully) 1. I understand that any misrepresentation or omission, as well as any misleading statements or omissions of application information, attachments, or supporting documents may result in denial of acceptance or removal from this volunteer position. 2. I certify that I am authorized to work in the United States. 3. 4. I give permission for all references, employers, organizations, or any others listed in this application to release any and all information that may relate to this appointment. I hereby authorize the Umatilla County Sheriff s Office to conduct a Criminal History Check and Background Investigation in connection with my application for Special Deputy within the Search and Rescue Unit. Signature: Date: INSTRUCTIONS You must print and sign this application for it to be accepted. Deliver or mail to the Umatilla County Sheriff s Office at the address listed on page one of this application. Please put Attention: Search and Rescue Sergeant on your envelope. If you have questions you may call during normal business hours or you may email us at sheriff@umatillacounty.net. Thank you for your interest in the Search and Rescue program. Page 5