Dispatch Observation Application

The Linn County Sheriff’s Office Dispatch Observation Program is intended to allow interested citizens, applicants, and other agency professionals a first-hand look at the day-to-day duties and obligations of a Linn County Sheriff’s Office Communications Dispatcher. Herein after referred to as “Observer”, agrees to the following conditions to be allowed to participate in the Dispatch Observation Program.

Identification
Name*
First Middle Last
Date of Birth*
MM slash DD slash YYYY
Social Security Number (SSN)*
Driver's License Number*
State of Issue*
Contact Information
Home Address*
Street Address Address Line 2 City State ZIP Code
Mailing Address (if different)
Street Address Address Line 2 City State ZIP Code
Email Address*
Home Phone*
Work Phone
Mobile Phone
Other Names Used
Emergency Contact
Name*
First Last
Phone*
Alternate Phone
Personal References
First Reference
First Middle Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Second Reference
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Additional Information
Current Occupation
Have you ever been arrested for any criminal offense?*
- no
- yes
Please explain the circumstances of your arrest:
Have you applied for an employment position with the LCSO?*
- yes
- no
Reasons for wanting to Observe Dispatch*
Please explain why you are requesting permission to observe our Dispatch Center at the Linn County Sheriff's Office.
Choose Days and Times
Please list two choices for days of the week and times of the day during which you would like to observe Dispatch.
First Choice: Day*
First Choice: Shift*
Second Choice: Day*
Second Choice: Shift*
Dispatch Observation Regulations and Agreement
Please read carefully before signing:*
Background checks including a check of LEDS, NCIC, Oregon criminal history and the FBI Index, must be conducted on you. Persons who have negative contacts with public safety agencies, recent or other criminal backgrounds may not be allowed to observe. Observer must provide photo ID, which must be either (a) driver’s license or ID Card issued by any state of the United States, or (b) passport. Observer will not bring any weapons on any kind (including, but not limited to firearms, knives, conducted energy weapon “Taser”, or chemical agents “pepper spray”) into the facility. Observer recognizes that during the observation, they could become a witness to offenses and criminal violations. Administration will provide the Observer’s name and address as a witness whenever applicable. The Observer acknowledges that as a witness, they may be subpoenaed to testify in court. Observer is reminded that any information learned during this observation is confidential. Observer agrees to not discuss or reveal such information that may potentially compromise investigations or the personal privacy of those involved in calls for service. All cellphone or accessories must be silenced and will not be used while in the facility. No photography, videotaping or audio recordings will be allowed without pre-authorization from Management. Observer does hereby release and discharge the Linn County Sheriff’s Office and County’s employees from all claims, present and future, known and unknown, in any manner arising out of property damage or personal injuries sustained as a result of the requested observation. I specifically waive any and all rights I have or may have under the Oregon Tort Claims Act (ORS 30.260 et seq.) or any other statute.
I have read, understand, and accept the regulations of the Dispatch Observation Program. In addition I have read the entire text of this application and understand it completely. The statements I have made are correct and true. I understand that making false statements on this application is a crime. If I have made false statements in this application, I am subject to prosecution and my application will automatically be denied or revoked.
- I certify that I intend my electronic signature on this Dispatch Observation Regulations and Agreement to be the legally binding equivalent of my traditional handwritten signature.
Signature*
Enter your full legal name.
Date Signed*
MM slash DD slash YYYY
Parental Endorsement
Required for applicants under the age of 18
I have read and understand the Release and Hold Harmless Agreement and agree to be bound to its provisions as they apply to my son/daughter named above. I agree to assume full responsibility for my son/daughter as it would pertain to the provisions set forth.
- I certify that I intend my electronic signature on this application to be the legally binding equivalent of my traditional handwritten signature.
Parent/Guardian Signature
Enter your full legal name.
Date Signed*
MM slash DD slash YYYY
Phone
This field is for validation purposes and should be left unchanged.

Dispatch Observation Application

Dispatch Observation Application

Identification

Contact Information

Emergency Contact

Personal References

Additional Information

Choose Days and Times

Dispatch Observation Regulations and Agreement

Parental Endorsement