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CASA Volunteer Application
You can download the CASA application
here
and submit it via email at info@athensoconeecasa.org or complete the form below.
Please complete all fields of the application prior to submission.
*
Indicates required field
How did you hear about the CASA program?
*
Billboard
Car Magnet
Personal Referral
Print (Ad, Brochure, etc.)
Radio
Social Media
Speaking Engagement
Special Event
Website
Yard Sign
Other
Click the arrow to choose an answer
General Information
Name
*
First
Last
[object Object]
Drivers License #
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SSN#
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Do you have active car insurance?
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Yes
No
Date of Birth
*
Sex
*
Female
Male
Intersex
Click the arrow to choose an answer
Ethnicity
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African American
Asian/Hawaiian
Caucasian
Hispanic
Multi Ethnic
Native American
Other
Marital Status
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Married
Divorced
Single
Widowed
Click the arrow to choose an answer
Contact Information
Preferred Phone Number
*
Type
*
Cell
Home
Work
Click the arrow to choose an answer
Secondary Phone Number
*
Type
*
Cell
Home
Work
Click the arrow to choose an answer
Email
*
Would you like to receive emails from CASA?
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Yes
No
Click the arrow to choose an answer
Emergency Contact Person
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Emergency Contact Number
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Home Address
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Line 1
Line 2
City
State
Zip Code
Country
Mailing Address (if different from above)
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Line 1
Line 2
City
State
Zip Code
Country
Years at current home address
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>1
1
2
3
4
5
6
7+
If less than 7 years, list previous address
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Line 1
Line 2
City
State
Zip Code
Country
Employment Information
Please choose any of the following statuses that apply
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Military
Student
Type of Employment
*
Contract
Full-time
Part-time
Retired
Unemployed
Click the arrow to choose an answer
Employer
*
Length of employment
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<1 year
1 year
2-4 years
5+ years
Position
*
Work Address
*
Line 1
Line 2
City
State
Zip Code
Country
Education/Skills Information
Please select highest level completed
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Some High School
High School
Some College
College Graduate
Post-Graduate
Click the arrow to choose an answer
Name of School and Degree Obtained
*
Primary Language
*
Language(s)
*
English
Spanish
French
German
Chinese
Vietnamese
Other
Select any training or experience (salaried or volunteer) in any of the following categories:
(NOTE: None is required to be a CASA Volunteer.)
Choose Any
*
Child care
Child development
Child welfare
Education
Arts/graphics
Fundraising
Choose Any
*
Drug/alcohol treatment programs
Health/mental health
Counseling psychology
Public speaking
Social work
Human Resources
Choose Any
*
Criminology/law enforcement
News/media
Writing/editing
Juvenile court
Advertising/public relations
Law
Describe any additional experiences that may be applicable to CASA.
*
List current and previous volunteer service and length of service.
*
Have you ever been involved with another CASA program?
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Yes
No
Click the arrow to choose an answer
If yes, which CASA program(s)?
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If applicable, what was your role?
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Have you ever worked for the juvenile court?
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Yes
No
Click the arrow to choose an answer
Have you ever worked for the Dept. of Family & Children Services or Child Protective Services?
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Yes
No
Click the arrow to choose an answer
Have you ever been a foster parent?
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Yes
No
Click the arrow to choose an answer
Currently?
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Yes
No
Click the arrow to choose an answer
List any charges, arrests, and/or convictions,
other than traffic violations
, and list dates, county/state, and disposition of each. (An applicant having a charge or conviction for a crime involving a sex offense, child abuse or neglect or related acts that would pose risks to children or the CASA program’s credibility is disqualified as a CASA volunteer. Applicants with other misdemeanor or felony charges or convictions that would not pose a risk to children or negatively affect the credibility of the CASA program will be considered on a case-by-case basis considering the time passed since the incident and the level of rehabilitation.)
Comment
*
Have you ever had a case with, or investigation performed by, the Department of Family and Children Services?
*
Yes
No
If yes, please explain:
*
Have you sought treatment for or are you currently in treatment for a mental health problem?
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Yes
No
Click the arrow to choose an answer
Additional information:
*
Training Information
When can you attend CASA training? Please check available times:
Monday
*
Morning
Midday
Evening
Tuesday
*
Morning
Midday
Evening
Wednesday
*
Morning
Midday
Evening
Thursday
*
Morning
Midday
Evening
Friday
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Morning
Midday
Evening
Saturday
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Morning
Midday
Evening
Sunday
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Morning
Midday
Evening
Do you prefer to work with a particular age group?
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Yes
No
Click the arrow to choose an answer
If yes, please choose ages:
*
0-2
3-5
6-8
9-12
13-15
16-18
Do you have access to transportation?
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Yes
No
Click the arrow to choose an answer
Do you have a driver's license?
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Yes
No
Click the arrow to choose an answer
If yes, license number:
*
State of license:
*
I affirm I have automobile insurance.
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Yes
No
References
Please list names and contact information of 4 people (2 professional – salaried or volunteer work – and 2 personal – no family members, please). If currently employed, please list supervisor first.
Name
*
First
Last
Relationship
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Phone Number
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Email
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Address
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Line 1
Line 2
City
State
Zip Code
Country
Name
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First
Last
Relationship
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Phone Number
*
Email
*
Address
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Line 1
Line 2
City
State
Zip Code
Country
Name
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First
Last
Relationship
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Phone Number
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Email
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Address
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Line 1
Line 2
City
State
Zip Code
Country
Name
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First
Last
Relationship
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Phone Number
*
Email
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Address
*
Line 1
Line 2
City
State
Zip Code
Country
Essay Questions
Please briefly answer the following questions. (Two to four sentences each is sufficient.)
Why do you want to be a CASA volunteer?
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What role should society play in protecting children while also preserving families?
*
Upload a short autobiography
Do more than list your milestones. Please cover a brief overview of your neighborhood and family life, your early role models and your adult accomplishments. Include, where possible, some analysis of your life’s direction and some discussion of goals met and future goals.
Short Autobiography
*
Max file size: 20MB
As a CASA volunteer, I will be willing to do the following:
*
Commit a minimum of 12 – 24 months to being a CASA volunteer*
Participate in the CASA program’s 50+ hour volunteer training
Participate in 12 hours of continuing education training annually
Visit in person with the child(ren) to whom I may be assigned at least monthly
Prepare written reports to the court with guidance from CASA staff
Participate and attend court hearings and meetings on my child’s case during business hours
Record and turn in a monthly log of my activities on my case
Disclose any criminal charge(s) if brought against me while serving as a CASA volunteer
*Varies by program, generally 12-24 months
I have read and agree to the duties listed above:
*
Yes
No
Click the arrow to choose an answer
Affirmation and Release
I hereby affirm that the information contained in this application is correct and accurate to the best of my knowledge. I understand that this information will be used in determining my eligibility as a Court Appointed Special Advocate, as well as to support any ongoing involvement with CASA. I understand that completing this application or gaining acceptance into the training does not of itself guarantee confirmation that I will be sworn in as a CASA volunteer or be appointed to a case and that such a decision is made after the entire screening and training process have been successfully completed. I further understand that both the CASA program and I have the ability to individually or mutually terminate this relationship at any point. This decision may occur at any time in the screening process, including after the interview or during the training, or after I am sworn in as a CASA volunteer. Any knowingly false or misleading statements or omissions made on this application or otherwise stated during the screening process shall be automatic grounds for dismissal.
I understand that the CASA program will protect and maintain my personal information. Information is collected and stored for purposes related to the recruitment, screening, training and retention of CASA volunteers and will not be sold to third parties.
Upon successful completion of my screening, training and acceptance as a volunteer, I understand that I will be expected to serve as an advocate for a length of time* as agreed upon/discussed with the CASA program personnel. If unforeseen circumstances prevent me from fulfilling this obligation, I will provide as much notice as possible and follow any procedures for notice, release and return of case-specific information, both digital and physical.
I am aware that I may have access to sensitive information during training and court observation. During training, I will be provided with detailed information about how to protect and maintain confidential documents, reports, evaluations and other material in my capacity as a CASA volunteer to avoid any unauthorized disclosure.
Full Name
*
Date
*
DISCLAIMER: By typing your name, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.
The criteria used in the selection of CASA volunteers are designed to ensure that the individual is able to meet the responsibilities of a CASA volunteer.
Submit
Home
Get Involved
Volunteer
>
Application
Ways to Give
Employment or Internship Opportunities
Do you have a request?
Request a CASA for a child
Request a Speaker
Meet Our Team
CASA Staff
Volunteers
News and Events
Events
Blog
Resources
Intranet for Volunteers
How to Get In Service Hours
CASA Report Resources
Researching your case
Relative Search and Culture
Collecting Medical Records
Community Resources
DFCS Policy and Documents
Educational Advocacy
CASA Connect
Contact Us
National CASA - GA CASA
Test Page
