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Court Appointed Special Advocated of Merced County Affirmation & Release Disclosure

I, (NAME OF POTENTIAL VOLUNTEER) hereby affirm that all of the answers provided are true.  I understand that by submitting this application, I am authorizing inquiries to be made concerning my suitability as a volunteer. This will include a background check and fingerprinting for any past criminal record. The information requested in the application except for demographic information will be used only for the purpose of determining my suitability to be a volunteer. All information will be held in confidence and all information obtained by the CASA program will be deemed to be the sole property of CASA of Merced County and shall not be made available to me or anyone outside of the agency.

I understand that any applicant found to have been convicted of or to have current charges pending for a felony or misdemeanor involving a sex offense, child abuse, or child neglect will not be accepted as a volunteer. Refusal to sign this application or submit to a background check will be cause for immediate rejection from the CASA program.

I understand that all volunteers are selected based upon their individual ability to meet the responsibilities of the CASA program. An adult otherwise qualified to act as a CASA will not be discriminated against based on marital status, socioeconomic factors, race, national origin, ethnic group identification, religion, age, sex, sexual orientation, color, or disability or because of any other characteristic listed or defined in Government Code section 11135 or Welfare and Institutions Code section 103.

I understand that I must complete the training program and spend 5 hours observing court proceedings before being sworn in as a Court Appointed Special Advocate.  I further understand that I must participate in ongoing training and supervision after certification. I understand that after successful completion of my training, and acceptance as an advocate, I will be expected to serve a minimum of 18 months in the CASA program and my duties may include court appearances, visits to the homes of family members and possibly visits to institutions or treatment programs.   If unforeseen circumstances prevent me from fulfilling this obligation, I will submit my written resignation to the CASA Executive Director as soon as possible. 

I understand that I must complete all mandatory training sessions.  I understand that I will not be able to serve as a volunteer until these sessions are completed as well as any additional requirements that the CASA staff may deem necessary.

I understand that when I leave the program, I will return all CASA training manuals, case files, ID badges, and all CASA materials obtained while serving as a volunteer with the program.  All materials will be returned within one week of separation from the program.

I am aware of the sensitive and confidential nature of the documents, discussions, and other material I will examine in my capacity as a volunteer advocate. I understand that any information I may receive or hear pertaining to a child or young adult and his or her circumstances is strictly confidential and may not be disclosed to anyone else.  I will discuss these matters only with those directly involved in the case.

I understand that the content of this page is an initial disclosure. The information on this page will be presented to me at a later date and time, in the form of an official document to be signed IN PERSON.
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