CASA VOLUNTEER APPLICATION



CONTACT INFORMATION


HOME ADDRESS


MAILING ADDRESS


EMPLOYMENT INFORMATION



EDUCATION AND EXPERIENCE(S)


Check any training or experience (salaried or volunteer) in any of the following categories:
(NOTE: None is required to be a CASA Volunteer)


AVAILABILITY AND PREFERENCES
When can you attend CASA training?

REFERENCES
Please list names and contact information of four (4) people (2 professionals – salaried or volunteer work – and 2 personal – no family members please). If currently employed, please list supervisor as your first reference.




NOTE:
It is important to list correct mailing addresses/email for your references so that we may contact them regarding your application to become a CASA volunteer.



AFFIRMATION AND RELEASE

I hereby affirm that all of the answers provided on my volunteer application are true. I understand that the information requested will be used only for the purpose of determining my suitability as a Court Appointed Special Advocate. I understand that this application does not ensure appointment as a CASA volunteer. I understand that completion of training does not guarantee that I will be assigned a case. After successful completion of my training, I further understand that I will be expected to serve a minimum of one year in the CASA program. If unforeseen circumstances prevent me from fulfilling this obligation, I will submit a written resignation to the program director with as much advance notice as possible.

I am aware that I will be examining sensitive, confidential documents, reports and other material in my capacity as a CASA volunteer. I will discuss these matters only with those persons directly involved in the case at the Court or those who will be consulted for their professional knowledge or expertise. I will not divulge this confidential information to anyone else.

I hereby authorize CASA and any law enforcement agency or other appropriate agency to receive any criminal history record information and state central registry information (from the Department of Family and Children Services) pertaining to me, which may be in files of any federal, state or local criminal justice agency in the United States, and to investigate my background to determine my fitness as a potential volunteer. This information may be requested and be received on a continual basis during the period of time that I am an active volunteer for the CASA program.

I certify that the answers given in this application are true and complete to the best of my knowledge, and understand that if accepted into the program as a volunteer, any false or misleading statements on this application shall be grounds for dismissal.

Please complete the following information needed for background checks: