carroll-county-casa
VOLUNTEER APPLICATION FORM
 
Name:
(Last) (First) (Middle)
Home Address:  
City: Country:
State: Zip Code:
     
Daytime Telephone No. Sex:    Male:   Female: 
Evening Telephone No. Ethnic Origin:
Current Employer:
Address: Telephone #:
Length Of Employment: Position/Occupation:
Have you ever worked for the Juvenile Court? Yes :    No:
Have you ever worked for the Department of Family & Children Services?  Yes:   No:
(Include service as a foster parent)
List any volunteer experience and how long:
List any other experience, education or
training related to dependent children and families:
Do you have a valid Georgia driver’s license?  Yes:   No:
Do you own or have access to a car?  Yes:   No:
Have you ever been convicted of any violation of the law other than minor traffic violations?  
Yes:   No:
Have you ever sought treatment for, or are you currently in treatment for, a mental health problem? 
Yes:   No:
How did you hear about the CASA program?
Why do you want to volunteer for CASA?
   
PERSONAL INFORMATION  
Marital Status: Married? Yes:   No:  
Children & Ages:
     
 EDUCATION OR OTHER TRAINING  
     
Name of School/Program                       Degree               Dates attended
     
REFERENCES:    
List two (2) personal references (only one from family member) AND two (2) professional references (Salaried or volunteer work).
 
 PERSONAL  
     
Name: Relationship:
Address:
City: State: Zip Code:
Telephone Number: (H) (W)
       
       
Name: Relationship:
Address:
City: State: Zip Code:
Telephone Number: (H) (W)
       
PROFESSIONAL  
 
Name: Relationship:
Address:
City: State: Zip Code:
Telephone Number: (H) (W)
       
       
Name: Relationship:
Address:
City: State: Zip Code:
Telephone Number: (H) (W)
       
 
I UNDERSTAND THAT INQUIRIES WILL BE MADE TO VERIFY ALL STATEMENTS MADE IN THIS APPLICATION, AND TO CONDUCT ANY OTHER INVESTIGATION DEEMED NECESSARY TO DETERMINE MY SUITABILITY TO ACT AS A CASA VOLUNTEER.  I UNDERSTAND THAT APPLICATION DOES NOT ASSURE MY ACCEPTANCE INTO THE PROGRAM.  I WILL BE RESPONSIBLE FOR ASSURING THAT MY REFERENCES WILL RETURN THE REFERENCE REQUEST FORM TO THE CASA PROGRAM.  I HAVE CAREFULLY CONSIDERED THE JOB DESCIPTION AND TRAINING SCHEDULE AND, IF ACCEPTED, WILL OFFER MY SERVICES AS A COURT APPOINTED SPECIAL ADVOCATE.
 

 

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