State Form 14387 – Fill Out and Use This PDF

5. Return form directly to:

WESTVILLE CORRECTIONAL FACILITY

PLEASE BE AWARE THAT THERE IS A STUN FENCE IN OPERATION. DO NOT TOUCH!!

P.O. BOX 473

CONTACT WITH THE FENCE MAY RESULT IN PHYSICAL INJURY AND PAIN.

WESTVILLE, IN 46391

ATTN: CLASSIFICATION DEPARTMENT

OFFENDER

Name of offender

DOC Number

INFORMATION

OFFENDERS DO NOT WRITE BELOW THIS LINE

APPLICANT—DO NOT LEAVE ANY INFORMATION BLANK!

APPLICANT INFORMATION

Applicant (or guardian) MUST complete this section!

APPLICANT INFORMATION

Name of Applicant (As it appears on applicant’s I.D. {If first initial only, provide copy of ID showing initial only.}){Please Print}

Date of birth

Sex

Male

Female

Address (number and street, city, state & ZIP code) {NO P.O. BOXES}

Your Relationship to the offender

Are you on parole or probation?

Are/were you an employee/volunteer of the IN Dept. of

Have you ever been arrested or convicted for a crime?

Corrections?

Yes

No

Yes

No

Yes

No

Please list any arrests or convictions (and their Dates) for other than minor traffic violations. List date of release

Signature of applicant (Everyone who is 9 yrs. or older must sign here):

from incarceration, parole, or probation.

Printed Name of Spouse.

Signature of Parent/Guardian (if applicant is under 18), also include a copy of the birth Cert. and guardianship

papers if applicable.

Printed name of parent/guardian:

FOR OFFICE USE ONLY

THE ABOVE OFFENDER WILL BE NOTIFIED OF THE

DECISION. IT IS HIS RESPONSIBILITY TO NOTIFY

Approved

Signature of approval

YOU. WE DO NOT GIVE OUT THIS INFORMATION

Disapproved

BY PHONE.

GUIDELINES FOR VISITORS

VISITATION: Each complex visits on separate days on a rotating basis excluding parole board days (please see schedule). Registration starts ½ hour before the start of visitation. Visits are at 9:00 a.m., 11:00 a.m. and 1:00 p.m. If you

are not here by 1:00 p.m., you will be unable to visit. We try to accommodate two (1) hour visitation. There will be no more than three (3) persons per visit; excluding babies in arms (Once a child starts to walk they are counted as

one of the three). Everyone including newborn babies must be on the approved visitation list.

IDENTIFICATION REQUIRED: Everyone sixteen (16) years or older must show a picture I.D. Visitors under eighteen (18) must be accompanied by their parent or legal guardian at all times while on the institutional grounds. Visitors

shall wear clothing that reflects the acceptable standards of the Westville Correctional Facility that shall pose no threat to security, custody, or the maintenance of order at this institution. ALL visitors are subject to being searched. No

items may be brought into the institution to the offender or taken out of the institution for the offenders. Visitors will be provided a copy of statute IC 45-44-3-9, addressing trafficking with offenders and this statute will be posted in the

visiting rooms.

Embracing is allowed at the beginning and the end of the visit. Holding hands during the visit is permissible.

Visitors enter the visiting areas at their own risk. The superintendent of this institution or his designee reserves the right to refuse privileges to anyone he deems not eligible or those who have created a breach of the institutional policy,

especially passing of any item between the offender and the visitor. Such items shall be considered contraband.

Registration starts ½ hour before the beginning of visitation . Your name must be on the approved visitation list. This includes children. NO EXCEPTIONS!!

ALL VISITORS ARE EXPECTED TO ABIDE BY THE RULES AND REGULATION OF THE WESTVILLE CORRECTIONAL FACILITY REGUARDING APPROPRIATE ATTIRE:

Female Visitors:

MALE VISITORS:

1. Under garments must be worn. This includes a slip if you wear a skirt or dress.

2. Shoes must be worn, with the exception of infants in arms.

1. Shoes, shirts, and undergarments must be worn.

3. Shorts, stretch pants*, haltertops, Crop tops or short shirts and sheer clothing are not

2. Shorts, Muscle shirts and camouflage clothing are not permitted to be worn while

permitted:

visiting.

Clothing can be no shorter than two (2) inches above the knee. No camouflage clothing will

3. No head attire shall be worn during visiting except as part of a religious practice

be permitted.

4. All jewelry, except wedding bands and medical I.D.’s, must be removed.

4. All jewelry, except wedding bands and medical I.D.’s, must be removed.

5. No coats or heavy sweaters will be permitted to be worn inside the visiting room.

5. No headgear shall be worn while visiting except as part of a religious practice.

6. No coats or heavy sweaters will be permitted to be worn inside the visiting room.

7. FOR BABIES ONLY – one (1) bottle or pacifier and one diaper.

*Anything with a stirrup on the leg or spandex pants is classified as “stretch pants”.

You are allowed to bring up to $20.00 in change per adult visitor for the vending machines.

LOCATION OF THE WESTVILLE CORRECTIONAL FACILITY

In Westville, Indiana: approximately one half (1/2) mile west of State road 421 at the intersection of State Road 2 and State Road 6. Easily accessible from I80/90 and I94.

PHONE: 219-785-2511 Ext. 4071

FAX: 219-785-4515