Attorney Status Application for Remote Video Visitation

If you are having problems with the application below, please see alternate method to submit application.

Alternate Method: This application may be signed and submitted electronically with attachments using Internet Explorer via the “Submit” button. Alternate method entails printing, signing by hand, scanning the printed form with the attachments, and faxing 321-690-1568.

* Attorney Name:

* Title:

* Organization Name:

* Applicant’s Organization Associated Email Address:

Must be the email address used to register with GTL.

* Organization Phone Number:

* Organization Fax Number:

* Organization Street Address:

Address Line 2:

* City:

* State:

* Zip Code:

* Upload Proofs of Identity:

Proof of identification is required; failure to attach the proofs will automatically deny the application. Personal identification proof requires a valid government issued photo ID (can include Driver's License; Local, State or Federal Government ID Card; Military ID; Passport; U.S. Immigration identification). Professional organization proof requires a valid professional license, professional organization membership cards, or professional organization issued ID badge.

Note: Files must be either JPG, JPEG, PNG or GIF format and under 2MB in filesize.

* Proof of Personal Identity:

* Proof of Professional Identity:

* Associates?:

Will any of your associates be participating in the video visitation session:

* Associate Information #1:

Associate's Name #1:

Associate's Title #1:

Associate's Proof of Personal Identity #1:

Associate's Proof of Professional Identity #1:

* Associate Information #2:

Associate's Name #2:

Associate's Title #2:

Associate's Proof of Personal Identity #2:

Associate's Proof of Professional Identity #2:

Note: If you require more than 2 associates please send them separately to: jailisp@bcso.us

* Confirm Statement:

I certify that the information provided in this application and its attachments are true, authentic and verifiable. If the information is unable to be verified by the BCSO Jail Complex Inspectional Services Unit, Attorney Status will not be granted for remote video visitation.

* Enter the code below: