Volunteer Application

Full Name

First

Middle

Last

Maiden Name

Have you been known by any other names? If so, fill them out here

Alternate Name

First

Middle

Last

Birthday

have If Reference

Email

Mobile Phone

Home Address

Address Line 1

Address Line 2

City

State

Zip Code

Have you lived in other cities in the last 10 years? If so, please enter those locations here

City and State

Anytown, USA

Are you currently employeed?

Yes
No

Previous Spouse or Spouses

Do you have any children?

Yes
No

Do you have a driver's license?

Yes
No

Driver's License Number

Issuing State

Have you ever been arrested?

Yes
No

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?

Why are you volunteering for this program?

How were you made aware of this program?

Are you aware of the required basic training?

Yes
No

Are you willing to participate in ongoing training and court appearances?

Yes
No

Do you have any personal/employment constraints that may restrict your time?

Yes
No

Emergency Contact

Emergency Contact Phone

Please list three personal references not related to you. On reference, a co-worker if employed. References will be verified.

Reference Name #1

First

Last

Reference Address #1

Address Line 1

Address Line 2

City

State

Zip Code

Reference Phone #1

Relationship #1

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Reference Name #2

First

Last

Reference Address #2

Address Line 1

Address Line 2

City

State

Zip Code

Reference Phone #2

Relationship #2

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Reference Name #3

First

Last

Reference Address #3

Address Line 1

Address Line 2

City

State

Zip Code

Reference Phone #3

Relationship #3

Applicants who are appropriate candidates for the volunteer position will be notified of their acceptance, in writing, within one week of their personal interview. Applicants will be informed about pre-service training at least two weeks prior to the required training. Applicants who are deemed to be inappropriate for the volunteer position will be notified of the rejection, in writing, within one week of their personal interview or immediately following the outcome of their background checks. The Director may determine at any time during the screening and training process, including prior to assigning the volunteer a case that the volunteer does not qualify to be a volunteer. The volunteer will be notified by the Director if such a determination is made. Disqualification by the Director prior to a case being assigned may not be appealed to the Board, unless it can be shown that the Director disqualified a volunteer in violation of Focus On Youth/CASA’s policy on discrimination or sexual harassment.

Focus on Youth / CASA

Focus on Youth / CASA

Have you been known by any other names? If so, fill them out here

Have you lived in other cities in the last 10 years? If so, please enter those locations here

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WE ARE HERE FOR THE CHILD

We ARE HERE TO CHANGE LIVES