INTERNSHIP PROGRAM 

APPLICATION  

APPLICATION CHECKLIST Please take the time to ensure your application is completed properly.  

 

TIPS: 

Check that your contact details are correct, neatly written, and 

properly spaced.  

Check that your email address is correct and legible.  

Make sure you are manually signing applications, electronic 

signatures will not be accepted.  

Be sure you meet the requirements of the program. 

 

SUBMISSION CHECKLIST: 

Please fax your forms to 713‐437‐4216 OR email all of your forms to 

pamela.ramirez@hcjpd.hctx.net. 

 

   Internship Application (2 pages)  

   Background Check Form (3 pages) 

 

   University Letter from Advisor/Professor 

 

Prospective Intern:  

 

Thank you for your interest in interning at the Harris County Juvenile Probation Department. 

Due to the nature of the services provided by HCJPD, we adhere to very strict confidentiality and 

security policies and take extra care in screening our applicants. All candidates must follow the 

application process outlined below.  

Interns are accepted during the spring, summer, and fall semesters. Applications and supporting 

documents must be received by the application deadline for the desired semester. Deadlines are: 

Spring Semester  December 1st  

Summer Semester  May 1st  

Fall Semester    August 1st  

Application 

All areas must be completed – electronic signatures are not accepted. Incomplete applications cannot 

be processed, which will result in a delayed response. By accepting this application packet, you release 

HCJPD from providing reason(s) for non‐acceptance.  

You must be 21 years of age or older. You must be 21 years old by the application deadline date. 

You must be enrolled in an accredited university. 

You must provide a letter from your school’s internship advisor/professor stating that the 

internship is for class credit, the minimum required internship hours, and the 

advisor’s/professor’s complete contact information. (HCJPD requires a minimum of 150 

internship hours.) 

You must provide a tentative schedule and HCJPD will try to accommodate your needs. 

You must include your top 3 placement sites. 

You must complete the Criminal Background Check forms. 

Interviews 

Once the background check has completed and cleared, potential interns will be contacted and 

interviewed by the Internship Committee.  

Acceptance 

Interns who have been accepted will be notified via phone or email. School advisors/professors will also 

be notified. Please note that this is a non‐paid internship. 

Orientation/Meetings 

All interns are required to attend the intern orientation before they begin working at their designated 

location. NO EXCEPTIONS WILL BE MADE. There will be monthly meetings throughout the semester that 

interns are also required to attend. These meetings will always be on a Friday. 

We thank you again for your interest and look forward to hearing from you.  

Harris County Juvenile Probation Department 1200 Congress Houston, TX 77002 Phone: 713-222-4848

Fax: (713) 437-4216

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INTERNSHIP APPLICATION

APPLICATION INFORMATION

Name: Date of Birth:

Current Address:

City: State: Zip Code: Tel.#:

Email:

Emergency Contact Person and Phone Number:

Do you have any relatives/friends who are currently employed by the HCJPD? Yes No

If yes, please list their names:

Do you have any relatives/friends who are presently under the jurisdiction of HCJPD? Yes No

If so, please list their names:

EMPLOYMENT INFORMATION

Current Employer: How long have you worked there?

Phone Number: Title/Position:

Current Work Schedule:

Is your work schedule flexible? (explain)

EDUCATION INFORMATION

Semester/Year for desired Internship: Internship Hours Required:

University: Degree: GPA:

Major: Expected Graduation Date:

Advisor’s Name/Tel./Email:

Desired Placement Sites: 1st: 2nd: 3rd:

(Refer to pg. 3)

Harris County Juvenile Probation Department 1200 Congress Houston, TX 77002 Phone: 713-222-4848

Fax: (713) 437-4216

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ADDITIONAL INFORMATION

What days/times do you plan to complete your internship hours?

Are you taking additional classes during your internship semester? If so, what days/times?

Other language(s) Spoken: Do you have reliable transportation?

Special skills, hobbies, or other interests:

Organizations you are associated with:

Why do you want to intern with HCJPD?

What is your career goal after graduation?

MEMO OF UNDERSTANDING I will respect the principles of confidentiality according to the Federal Privacy Act of 1977 and Chapter 58 of the Texas Family code; and understand that if I release any

information about a juvenile, I will not be able to continue as an intern.

I will keep current Automobile Liability Insurance for my personal vehicle during my internship/volunteer service. I assume complete responsibility for any injuries,

physical or mental, which I might sustain during the internship.

I understand and agree that my application will be reviewed. I will submit the required university reference, give my permission for a criminal record check of my

background and fingerprinting to be done before my internship/volunteer service. I understand that any false information on my application may be cause for dismissal

from the internship/volunteer program. I also understand that this information will be kept in the strictest confidence and only released with my permission.

I understand that I will be expected to attend an orientation session in order to become familiar with necessary policies and procedures. The intern training will be

provided by trained staff of the Harris County Juvenile Probation.

Further, I agree to maintain regular communication with my supervising staff member and be reliable in reporting for scheduled assignments.

I understand if I am charged with a criminal offense I must report this information the next working day to my supervisor or program for which I am volunteering. On the

same day, the supervisor/program director must report the charge to the office of Administrative Services of the Harris County Juvenile Probation Department. I will

perform no other volunteer responsibilities after this criminal offense charge is made until I am given written clearance to do so by HCJPD. HCJPD will evaluate this

charge on an individual basis. I understand that depending on the nature and seriousness of the offense, I may be asked to discontinue my activities.

Applicant Signature: Date:

Electronic signatures are not accepted. Please print and sign your form.

Harris County Juvenile Probation Department 1200 Congress Houston, TX 77002 Phone: 713-222-4848

Fax: (713) 437-4216

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HCJPD INTERN PLACEMENT SITES PLEASE INDICATE TOP 3 CHOICES ON YOUR APPLICATION

SITES ADDRESS OVERVIEW

Intake Services

Downtown (Must pay for parking)

1200 Congress St., Houston, TX 77002

Serves as the entry point for youth referred to the juvenile justice system through the operation of a 24-hour detention intake unit, determining the need for secure detention or possible diversion. The division also supervises youth who are eligible for release utilizing community based approaches.

Court Services Downtown (Must pay for parking)

1200 Congress St., Houston, TX 77002

Supports the judicial process by providing comprehensive profiles and dispositional recommendations for use in court proceedings.

C.U.P.S. 1 NRG Stadium Area

2525 Murworth, Houston, TX 77054

Provides field supervision and rehabilitative services for youth and their families. (traditional probation supervision)

C.U.P.S. 2 Eastex/Jensen

9111 Eastex Freeway, Houston, TX 77093

Provides field supervision and rehabilitative services for youth and their families. (traditional probation supervision)

C.U.P.S. 3 Pasadena

101 S. Richey, Suite A, Pasadena, TX 77506

Provides field supervision and rehabilitative services for youth and their families. (traditional probation supervision)

C.U.P.S. 4 Northwest Harris County

5815 Antoine, Houston, TX 77091

Provides field supervision and rehabilitative services for youth and their families. (traditional probation supervision)

YESS Program

Southwest Houston

6500 Chimney Rock Rd. Cottage 6,

Houston TX 77081

The Youth Empowerment Services and Supervision Program works with juveniles placed on probation for known gang-related behavior or involvement.

C.U.P.S. 8 Spring Branch Area

1721 Pech Rd., Suite # 207, Houston TX 77055

Provides field supervision and rehabilitative services for youth and their families. (traditional probation supervision)

RISE Program NRG Stadium Area

2525 Murworth, Houston, TX 77054

Provides intensive services and intensive supervision for TJJD eligible youth who are assessed as high-risk.

C.U.P.S. 9 (TCU) NRG Stadium Area

2525 Murworth, Houston, TX 77054

Provides intensive services and supervision for youth with identified mental health needs and youth with an adjudicated sexual offense.

Service Learning Center NRG Stadium Area

2525 Murworth, Houston, TX 77054

Provides service learning projects and community service restitution for youth. Participation in service learning and/or community service is based upon court order, specialized program requirements, and Juvenile Probation Officer recommendation.

Diversion and Intervention Division (Deferred Unit)

Eastex/Jensen

9111 Eastex Freeway, Houston, TX 77093

Diverts youth from further involvement in the Juvenile Justice System by providing informal alternatives to formal court proceedings and targeted, strength-based individualized services to the youth/family.

Specialty Courts

(GRIP Court, Court 360,

CARE Court, SOAR, & Dual

Status)

Downtown (Must pay for parking)

1200 Congress St., Houston, TX 77002

The GRIP Court works gang involved youth by redirecting them towards healthier alternatives to gang activity. Court 360 addresses the underlying clinical component of delinquent behavior in mentally ill juvenile offenders. CARE Court works with youth who are actively engaged in or at risk of becoming involved in commercial sexual exploitation. SOAR Drug Court Program works with youth that have been identified with a substance abuse or dependence diagnosis. Dual Status works with youth involved with the Juvenile Justice system and in the custody of child welfare.

Harris County Leadership

Academy (secure placement facility)

Katy

9120 Katy-Hockley, Katy, Texas 77449

Facility that houses youth ages 10-17. Youth receive services such as: academic programs, individualized treatment approaches to meet their needs, evidence based programming, and wrap around services.

Harris County Youth Village

(secure placement facility)

Seabrook (NASA Area)

210 JW Mills Rd, Seabrook, TX 77586

Facility that houses youth ages 10-17. Youth receive services such as: academic programs, individualized treatment approaches to meet their needs, evidence based programming, and wrap around services.

C.U.P.S. = Community Unit Probation Services

For degrees other than Criminal Justice, please make a note on your application. (Ex. Training, Technology and Systems Development, Education, etc.)

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BACKGROUND CHECK FORM (Part A) Criminal Check

Harris County Juvenile Probation Department

Administrative Services 1200 Congress

Houston, Texas 77002

Pursuant to Title 37, Part 11, Chapter 344 of the Texas Administrative Code, the Harris County Juvenile Probation Department (HCJPD) performs fingerprint-based criminal history checks on service providers, interns, volunteers, and mentors. In addition, per HCJPD policy, the department performs initial and annual criminal history checks through TCIC/NCIC. This form must be completed and signed by the applicant prior to processing both initial and annual criminal history checks. SUBMISSION INSTRUCTIONS HCJPD background check forms contain three parts which are used to process checks in three separate databases. All sections (Part A Part B, and Part C) of this form must be completed in full (including duplicate information), A and B sections both require a signature and date. Any incomplete applications will not be processed. Upon completing, please scan and save all pages of this form in the following format: Last Name, First Name for Name of Organization (Example: Smith, Bob for Vision Keepers) Then email this form to: CriminalHistoryCheck@hcjpd.hctx.net or fax this form to: 832-927-0363 REFERRING AGENCY INFORMATION Community Partner/Vendor:

Date Sent:

Community Partner/Vendor Contact: Community Partner/Vendor Contact Email: PURPOSE OF CRIMINAL CHECK New Intern New Volunteer New Vendor

Annual Renewal Intern Annual Renewal Volunteer Annual Renewal Vendor

INTERN, VOLUNTEER, OR VENDOR INFORMATION PLEASE ENTER YOUR FULL LEGAL NAME BELOW

FIRST MIDDLE LAST

STREET ADDRESS CITY STATE ZIP

DATE OF BIRTH SOCIAL SECURITY # ID Card# / Driver’s License # Issuing State GENDER

APPLICANT PRIMARY TELEPHONE # APPLICANT EMAIL ADDRESS

Have you ever been employed by the Harris County Juvenile Probation Department? ☐YES ☐NO Do you currently have any family members under the supervision of the Harris County Juvenile Probation Department? ☐YES ☐NO Have you ever had a JPO or JSO Certification revoked by the Texas Juvenile Justice Department? ☐YES ☐NO CRIMINAL CHECK AUTHORIZATION By virtue of my signature I certify the name, address, personal descriptive information is accurate as recorded on this document and I hereby authorize the Harris County Juvenile Probation Department to perform a criminal history background check. Signature of Applicant: ________________________________________________ Date: ______________

Applicant must provide handwritten signature, no electronic signatures will be accepted

HCJPD USE ONLY- APPLICANT DO NOT WRITE BELOW THIS LINE I certify that a records check has been completed on the above listed person. Applicant was found to be:

☐ACCEPTABLE ☐UNACCEPTABLE Signature of Person Completing Check: ______________________________________ Date: _____________

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BACKGROUND CHECK FORM (Part B) Child Abuse/Neglect Central Registry Check Harris County Juvenile

Probation Department

Administrative Services 1200 Congress

Houston, Texas 77002

I authorize the Harris County Juvenile Probation Department to submit a request for a Texas Department of Family and Protective Services (DFPS) Central Registry Abuse and Neglect check on me as required by the Prison Rape Elimination Act (PREA) standards and HCJPD Policies relating to enlisting the services of any vendor/volunteer who may have contact with residents in juvenile facilities. I understand DFPS maintains a central registry of reported cases of child abuse and neglect, which includes, information gathered during Child Protective Services (CPS), Child Care Licensing (CCL), and Adult Protective Services (APS) facility investigations of child abuse and neglect that resulted in a disposition of “reason to believe” for CPS and CCL cases or “confirmed and validated” for APS cases. I understand that I will not clear the Central Registry check if: • I have the role of designated perpetrator or sustained perpetrator in an investigation included in the registry; or • I am involved as an alleged perpetrator in an open child abuse or neglect investigation being conducted by DFPS. As the subject of the request, I have the right to receive the results of the check and to share them with any third party. I further understand if the check results in a match as described above, DFPS will only send the results directly to me via mail or email. Please complete each field below, ALL INFORMATION IS REQUIRED to process the requested Central Registry Check; missing information may result in a delay of the request. FIRST NAME MIDDLE NAME LAST NAME

Other names or spellings used (married, maiden, alias etc.) – First, Middle, Last (continue on back as need)

CURRENT ADDRESS CITY COUNTY STATE ZIP CODE

SOCIAL SECURITY NUMBER DATE OF BIRTH GENDER PRIMARY DAYTIME TELEPHONE #

☐ Female ☐ Male

Type: ☐ Cell ☐ Home ☐ Business/Work ETHNICITY RACE ☐ Hispanic ☐ Unable to Determine ☐ Not Hispanic

☐ White ☐ Asian ☐ Black ☐ American Indian/Alaskan Native ☐ Unable to Determine ☐ Native Hawaiian/Pacific Islander

List all known physical addresses for the past 10 years (continue on back if needed) VENDOR/VOLUNTEER ACKNOWLEDGEMENT I certify that there are no willful misrepresentations, omissions, or falsifications in the aforesaid statements and answers. I am aware that should any investigation disclose any misrepresentations, omissions, or falsifications, my request to provide volunteer/vendor services may be rejected or if already providing services, my volunteer/vendor services may be terminated. PRINTED NAME EMAIL ADDRESS

SIGNATURE

Applicant must provide handwritten signature, no electronic signatures will be accepted

DATE

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BACKGROUND CHECK FORM (Part C) Fingerprint Applicant Services of Texas (FAST)

Administrative Services 1200 Congress

Houston, Texas 77002

After clearing the initial required background checks in parts A/B of this form, HCJPD requires fingerprint-based criminal history checks and enrollment in FAST for all service providers, interns, volunteers, and mentors. HCJPD Administrative Services Staff will schedule a FAST appointment based on the information completed below. Please submit a copy of your driver’s license, State ID or Passport with this Background Check Form (Proof of Identification).

**IMPORTANT- Please Complete Information as it Appears on Your Proof Of Identification **You must bring this proof of identification to your scheduled FAST Appointment

First Name

Middle Name (or list NMN) Last Name Suffix (Sr., Jr., III)

Address (Street, City, Zip Code) Is the address on your proof of identification the same as where you currently live? ☐ YES ☐ NO (If no, list current address,) Have you ever used a maiden name or alias? ☐ YES ☐ NO (If yes, list all, please write FIRST MIDDLE LAST maiden name or alias)

CITIZENSHIP Date of Birth (MM/DD/YY)

Country of Birth State/Providence of Birth Country of Citizenship

PHYSICAL CHARACTERISTICS Height (ft./in.)

Weight (lbs.) Hair Color Eye Color

Race Gender

CONTACT INFORMATION Email Address

Primary Telephone #

What is the name of organization/community partner/vendor you will be volunteering or providing services for?

FINGERPRINT APPLICANT SERVICES OF TEXAS (FAST) PROCESSING APPOINTMENT HCJPD Administrative Services Staff must schedule a fingerprint appointment for you, attached (page 4) are the FAST processing appointment locations. Please list your preferred appointment location by location number and location name (for example, LOCATION 3, HEMPSTEAD), day of the week and time frame. Preferred FAST Appointment Location

Preferred Day(s) of Week Preferred Time of Day

2ND Choice FAST Appointment Location

Preferred Day(s) of Week Preferred Time of Day

Proof of identification you will be providing for FAST appointment ☐ Driver’s License ☐ Commercial Driver’s License ☐ State ID ☐ Passport

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APPENDIX I.

FINGERPRINT APPLICANT SERVICES OF TEXAS (FAST) PROCESSING LOCATIONS LOCATION # LOCATION ADDRESS WEEKDAY HRS SATURDAY HRS

LOCATION 1

BAYTOWN 4804 East Freeway, Baytown, TX

Mon - Thu 8:30 am-5:30 pm Fri- 8:30 - 6:00

8:30 am - 3:00 pm

LOCATION 2 DEER PARK 3717 Center St., Ste C, Deer Park, TX

Mon - Fri 8:00 am - 5:00 pm None

LOCATION 3 HEMPSTEAD 701 Calvit St., Hempstead, TX

Mon - Fri 9:30 am - 4:00 pm None

LOCATION 4 HOUSTON - KATY FREEWAY 11111 Katy Fwy, Ste 750, Houston, TX

Mon - Fri 8:30 am – 4:30 pm None

LOCATION 5 HOUSTON - NORTH 8418 Veterans Memorial, Houston, TX

Mon - Fri 9:00 am - 4:00 pm None

LOCATION 6 HOUSTON - NORTHWEST 20465 State Highway 249, Houston, TX

Mon - Fri 8:00 am - 5:00 pm None

LOCATION 7 HOUSTON - SOUTH LOOP 3262 South Loop W, Houston, TX

Mon - Fri 8:00 am - 8:00 pm 8:00 am - 2:00 pm

LOCATION 8 HOUSTON - NW BELTWAY 11250 Charles Rd., Jersey Village, TX

Mon - Fri 8:00 am - 5:00 pm None

LOCATION 9 KINGWOOD 4311 Kingwood Dr., Kingwood, TX

Mon - Thu 8:00 am - 6:00 am Fri 8:30 am - 5:00 am

9:00 am - 3:00 pm

LOCATION 10 LAKE JACKSON 145 Oyster Creek Dr., Ste 7a, Lake Jackson, TX

Mon - Fri 10:00 am – 5:00 pm 10:00 am - 6:00 pm

LOCATION 11 LAMARQUE – GULF PLAZA 11001 Delany St., Ste 15005, LaMarque, TX

Mon - Fri 8:00 am -5:00 pm None

LOCATION 12 MAGNOLIA 32731 Egypt Ln., Ste 503, Magnolia, TX

Mon - Fri 8:00 am - 4:30 pm 9:00 am - 3:00 pm

LOCATION 13 PEARLAND 2010 East Broadway, Pearland, TX

Mon - Fri 8:00 am - 5:00 pm 9:00 am - 3:00 pm

LOCATION 14 SPRING 4405 Spring Cypress Road, Ste 112, Spring, TX

Mon - Fri 8:00 am - 8:00 pm 9:00 am - 3:00 pm

LOCATION 15 SUGAR LAND 13515 Southwest Freeway, Sugar Land, TX

Mon – Fri 8:30 am - 1:00 am; 1:30 am - 4:40 pm

None

Please do not email of fax this FINGERPRINT APPLICANT SERVICES OF TEXAS (FAST) PROCESSING LOCATIONS page in with your Criminal Background Application.