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Victim Advocate Application

  1. Natrona County Sheriff's Office
    Gus Holbrook - Sheriff
    Victim's Response Unit
    Dalene Asmus - Victim Services Coordinator
    201 N. David - 2nd Floor
    (307) 235-9338 Telephone
    (307) 235-8252 Fax
    dasmus@natronacounty-wy.gov

  2. Victim Advocate Application

  3. All applicants are considered without regard to race, color, religion, sex, national origin, age, marital or veteran status, or the presence of non-job related medical condition or handicap.

  4. Can you drive?

  5. Have you ever been convicted of a felony?

  6. Have you had a traffic ticket?

  7. Are you a Veteran of the U.S. Military Services?

  8. Do you speak a foreign language?

  9. Please list your last three employers:

  10. Please list at least three personal references that we may speak to. Please make sure these people are not related to you. You may have worked with them, for them or been involved in a volunteer organization with them.

  11. Special Employment Notice to Disabled Veterans, Vietnam Era Veterans, and Individuals with Physical or Mental Handicaps.

    Government contractors are subject to 38 USC 2012 of the Vietnam Era Veterans Readjustment Act of 1974 which requires that they take affirmative action to employ and advance in employment qualified disabled veterans and veterans of the Vietnam Era, and Section 503 of the Rehabilitation Act of 1973, as amended, which requires government contractors to take affirmative action to employ and advance in employment qualified handicapped individuals.

    If you are a disabled veteran, or have a physical or mental handicap, you are invited to volunteer this information. The purpose is to provide information regarding proper placement and appropriate accommodation to enable you to perform the job to the best of your ability in a proper and safe manner. This information will be treated as confidential. Failure to provide this information will not jeopardize or adversely affect your consideration for employment.

  12. If you wish to be identified, please type your name below.

  13. Check all that apply

  14. Are there any special requirements that need to be met during the written and oral phase of testing?

  15. APPLICANTS STATEMENT AND BACKGROUND INVESTIGATION WAIVER

  16. I certify that the answers given herein are true and complete to the best of my knowledge. In the event of acceptance, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Agency.

    I authorize investigation of all statements contained in this application as may be necessary in arriving at a decision concerning acceptance or rejection as a volunteer victim advocate. I understand that this application is not intended to be a contract of employment.

    By typing my name below, I hereby authorize the Natrona County Sheriff's Office to conduct an intensive background investigation on my character. I understand that any and all information obtained will be held strictly confidential. I further understand that the background investigation will include the interview of my past and present employers.

  17. Leave This Blank:

  18. This field is not part of the form submission.