Volunteer Application Posted on February 18, 2019May 9, 2019 by kincade Click here to open our Volunteer Application Form. The PDF will open in a new tab. Alternatively, you may complete the form below: Volunteer Application Form Name* First Middle Last Home address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email address* Date of birth* Date Format: MM slash DD slash YYYY Gender*Please selectMaleFemalePrimary phone*Secondary phoneEmergency phoneEmergency contactEmployment status*Please selectFull timePart timeNot employedStudentRetiredEmployerWork phoneBrief description of workEthnicity*African-AmericanAsian-AmericanWhiteLatinoNative AmericanOtherPlease specifyWhich languages are you proficient in?*Please list current community activitiesPlease list all current and previous work, including brief description of duties and activites and dates of serviceAs a CASA volunteer, you will be required to attend court hearings for the children you represent.Will you be able to arrange your schedule to attend these hearings?*Please selectYesNoAre you willing to commit one year of volunteer services?*Please selectYesNoHave you had any personal experience(s) involving the following? Child welfare Court system Foster care Other agencies offering child services Please explainHow did you learn of our program?*Please selectFlierWord of mouthInternetLocal newspaperLocal radioNational mediaNCASAAVolunteer referral agencyOtherPlease specify*Have you ever been convicted of a crime other than a traffic violation?*Please selectYesNoWhat was the charge, when was the conviction, and where were you convited?*Do you consent to a routine check of your criminal records?*Please selectYesNoRefusal to consent to a complete background check shall be grounds for rejection of an applicant.If you can think of any reason why a judege might be relucant for you to serve as a CASA volunteer, please explain belowHighest level of education*Some high schoolGEDHigh SchoolSome collegeCollegePost-graduateOtherMajor*Degree*Name of school*Please answer the following questions in paragraph form.Write a short summary about your interest in volunteering and how you hope to benefit from the volunteer experience*Briefly explain what led to your decision to apply for a position in the CASA program*What experience do you have working with children?Please list 3 references of people who know you well, other than relatives, preferably for whom you have worked in either a paid or volunteer capacity. If you are currently working, either paid or volunteer, please include the name of your supervisor.*NameRelationshipAddressPhoneEmail Click the plus icon to add another reference. Please include 3.CommentsThis field is for validation purposes and should be left unchanged.