Volunteer Application

Section 1: Personal Information

Name*

Other Names

Address*

Home Phone*

Cell Phone

Work Phone

Fax Number

Email*

Date of Birth*

Place of Birth

Sex

Male
Female

Are you a licensed, insured MN driver?

Yes
No

Drivers License

Please indicate the county in which you desire to serve as a Guardian ad litem

Hennepin (Fourth Judicial District)
Ramsey (Second Judicial District)

Ethnicity

Do you have special needs which may necessitate reasonable accommodations in the interviewing process or in performing the essential funtions of the position for which you are applying?

Emergency Contact

Name

Phone

Relationship

Section 2: Employment Experience

Employment Experience #1

Company 1

Position 1

Supervisor 1

Phone 1

Date From

Date To

Employment Experience #2

Company 2

Position 2

Supervisor 2

Phone 2

Date From

Date To

Employment Experience #3

Company 3

Position 3

Supervisor 3

Phone 3

Date From

Date To

Section 3: Education

Select Highest Completed

High School

College

Graduate School

Major

Degree

Currently enrolled in school?

No
Yes, part time
Yes, full time

Expected Graduation Date

Will you receive academic credit for your volunteer work?

No
Yes

Section 4: Special Skills and Experience

List any community groups in which you are presently active (professional associations, faith communities, service organizations, etc)

Do you have any experience working with children?

No
Yes

If yes, please give organization names and details

Please note any professional licenses or certifications, including license numbers.

Section 5: Volunteer Experience

Child Welfare System:

No
Yes

Criminal Court System:

No
Yes

Juvenile Court System:

No
Yes

Family Court System:

No
Yes

If yes, please explain (include date and location in explanation).

Have you ever served as an advocate for any person or group in a position other than a Guardian ad Litem/CASA (Court Appointed Special Advocate)?

No
Yes

Have you ever served as a Guardian ad Litem or CASA (Court Appointed Special Advocate)?

No
Yes

Have you ever been involuntarily discharged or terminated from a Guardian ad LItem or CASA (Court Appointed Special Advocate) program or training?

No
Yes

Have you ever been denied the opportunity to enlist in a Guardian ad Litem or CASA (Court Appointed Special Advocate) training program?

No
Yes

Please explain briefly why you are interested in becoming a Guardian ad Litem/CASA (Court Appointed Special Advocate) for Children:

How did you hear about this opportunity (i.e., from a friend, advertisement, radio/TV, FaceBook, Twitter or other media - please be specific):

Please answer the following questions and give details if answer is yes:

If you are/have been an attorney, what is your license number?

If you are/have been an attorney, have you ever had your license revoked or suspended? Please explain.

Please list your previous volunteer experience:

Organization 1 Name

Organization 1 Address

Organization 1 Phone

Organization 1 Supervisor

Organization 1 Dates

Organization 2 Responsibilities

Please fill out if you have volunteered at another organization:

Organization 2 Name

Organization 2 Address

Organization 2 Phone

Organization 2 Supervisor

Organization 2 Dates

Organization 2 Responsibilities

Please fill out if you have volunteered at another organization:

Organization 3 Name

Organization 3 Address

Organization 3 Phone

Organization 3 Supervisor

Organization 3 Dates

Organization 3 Responsibilities

Section 6: Training and Availability

Will you be available for court appearance during the day?

No
Yes

Can you see yourself visiting with a family in their home to gather information?

No
Yes

Are you available to complete 40 hours of Pre-Service Training?

No
Yes
I already completed my training

Are you able to serve as a Guardian ad Litem/CASA (Court Appointed Special Advocate) for at least the next 18 months?

No
Yes

If you answered "No" to any of the previous questions, please explain:

Section 7: References

Please provide COMPLETE contact information for at least three non-family references that have known you for at least one year.

Please include both a personal and professional reference. If possible, please list an employer or supervisor.

Reference 1

Reference 1 Phone

Reference 2 Address

Reference 1 Email

Reference 1 Relationship

Reference 2

Reference 2 Phone

Reference 2 Address

Reference 2 Email

Reference 2 Relationship

Reference 3

Reference 3 Phone

Reference 3 Address

Reference 3 Email

Reference 3 Relationship

Reference 4

Reference 4 Phone

Reference 4 Address

Reference 4 Email

Reference 4 Relationship

Section 8: Consent and Privacy

Any applicant found to have been convicted of or having charges pending for a felony or misdemeanor involving a sex offense, child abuse or neglect, or related acts that would pose risks to children or the CASA program's credibility is not eligible to be a CASA volunteer. I, hereby affirm that all of the answers provided on my volunteer application are true. I hereby authorize CASA, Inc., and any law enforcement agency they authorize, to investigate my background to determine my fitness as a potential volunteer. I understand that the information requested in this application will be used only for the purpose of determining my suitability as a CASA volunteer. Further, I understand that completion of training does not guarantee that I will be assigned a case. If I have successfully completed the training and have met all other requirements, and it has been determined that I am a suitable volunteer, I understand that I will be expected to serve a minimum of 18 months in the CASA program. If unforeseen circumstances prevent me from fulfilling this obligation, I will submit my written resignation to the program director with as much advance notice as possible. I am aware of the sensitive and confidential nature of the official documents, reports and other material I will examine in my capacity as a CASA volunteer. I will discuss these matters only with those persons directly involved in the case or who will be consulted for their professional knowledge and expertise. I also understand that if for any reason it becomes apparent that my activities are contrary to the policies, goals and/or philosophy of the CASA program, and their desire to provide quality services to abused and neglected children, my services as a CASA volunteer will be terminated. I submit the statements on this application are true, complete, and correct to the best of my knowledge. I understand that falsification on this application can disqualify me from consideration or can result in dismissal at a later time.

Full Name*

Date*

CAPTCHA

Apply to be a CASA Volunteer

Section 1: Personal Information

Emergency Contact

Section 2: Employment Experience

Employment Experience #1

Employment Experience #2

Employment Experience #3

Section 3: Education

Select Highest Completed

Section 4: Special Skills and Experience

Section 5: Volunteer Experience

Please answer the following questions and give details if answer is yes:

Please list your previous volunteer experience:

Please fill out if you have volunteered at another organization:

Please fill out if you have volunteered at another organization:

Section 6: Training and Availability

Section 7: References

Please provide COMPLETE contact information for at least three non-family references that have known you for at least one year.

Section 8: Consent and Privacy

Send us an email

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Apply to be a CASA Volunteer

Section 1: Personal Information

Emergency Contact

Section 2: Employment Experience

Employment Experience #1

Employment Experience #2

Employment Experience #3

Section 3: Education

Select Highest Completed

Section 4: Special Skills and Experience

Section 5: Volunteer Experience

Please answer the following questions and give details if answer is yes:

Please list your previous volunteer experience:

Please fill out if you have volunteered at another organization:

Please fill out if you have volunteered at another organization:

Section 6: Training and Availability

Section 7: References

Please provide COMPLETE contact information for at least three non-family references that have known you for at least one year.

Section 8: Consent and Privacy

Send us an email

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