Volunteer Application

Court Appointed Special Advocate

This volunteer application form is designed to server the same purpose as that of an employment application. The CASA (Court Appointed Special Advocate) Program reserves the right to make any reference checks or inquiries deemed appropriate and necessary on the suitability of any new volunteer (just as reference checks are made on new employees).

We trust that you will understand this in the spirit intended. Any checks or inquiries will be kept in strict confidence.

Please be aware that our standards for volunteers are high and not all people who apply will necessarily be accepted.

Work with abused and neglected children as a CASA volunteer is extremely rewarding. We are looking forward to talking to you about becoming part of our dedicated corps of volunteers.

Fields marked with * are required.

Identification Info 
First Name * 
Middle Name * 
Last Name * 
Maiden Name   
Have you been known   
by any other names? * 
If yes, enter those here   
Date of Birth * 
Social Security * 
 
Home Address 
Home Phone * 
Email Address * 
Mailing Address * 
City * 
State *  Zip *
In what cities have you   
resided in the last ten years? * 
 
Employment Info 
Employed By * 
Business Phone * 
Business Address * 
Full Time / Part Time? * 
May we contact you at work? * 
 
Marital Info 
Marital Status * 
Previously Married * 
Spouse's Name   
(include previous spouses)   
Do you have any children? * 
 
Driving Info 
Do you have a car   
available to you? * 
Insurer Name * 
Driver's License No. * 
State * 
Expiration Date * 
 
Other Information 
Have you've ever been arrested? * 
If yes, please explain   
List previous volunteer work   
and contact person for each * 
Educational Background * 
What languages do you speak? * 
Do you prefer any particular   
age group / type of client? * 
 
Volunteering Info 
Why are you volunteering   
for this program? * 
How were you made aware   
of this program? * 
Are you aware of the   
required basic training? * 
Are you willing to participate   
in ongoing training and court appearances? * 
If no, please state why   
Do you have any personal   
/ employment constraints that may restrict your time? * 
If yes, please state why   
Emergency Contact * 
Emergency Contact Phone * 
 
References 
Please list three personal references not related to you. On reference, a co-worker if employed. References will be verified.
 
Reference #1 
Name * 
Work Phone * 
Home Phone * 
Mailing Address * 
City * 
State *  Zip *
Relationship * 
 
Reference #2 
Name * 
Work Phone * 
Home Phone * 
Mailing Address * 
City * 
State *  Zip *
Relationship * 
 
Reference #3 
Name * 
Work Phone * 
Home Phone * 
Mailing Address * 
City * 
State *  Zip *
Relationship * 
 
 * Please type in verification code