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Become a Volunteer / Advocate

CASA VOLUNTEER ONLINE APPLICATION

 


Before you begin the application:

  • Please read the Affirmation & Release Initial Disclosure (link below).

  • Be advised that you will need approximately 45 minutes to complete this application.

  • The application must be completed in one sitting.

  • Read all questions and instructions thoroughly.

  • Incomplete applications will not be considered. 

By completing the CASA Volunteer Online Application you acknowledge and accept the CASA Affirmation & Release Initial Disclosure
 

BEGIN APPLICATION:


 

How did you hear about CASA?
(Check all that apply)

Section 1: Personal Information

Legal First Name
Legal Middle Name, if applicable
Legal Last Name
Home Address
Country
Address Line 1
City
State
Postal Code
Mailing Address Same as Home Address?
If no, please enter mailing address:
Country
Address Line 1
City
State
Postal Code
Home Phone Number
Cell Phone Number
Work Phone Number
May we call you at work?
Gender
Date of Birth (MM/DD/YYYY). Volunteers must be 21 or older.
Place of Birth (City, State & Country if outside US)
Emergency Contact (First & Last Name, Relationship)
Emergency Contact Phone Number
Ethnicity
If Other, please specify below
Resident of Merced County for:
If applicable, please list other states you have lived in.
Marital Status
If married, please provide spouse's name & occupation
Please enter the names and ages of your children
Please list the names & relation to all other household members not previously mentioned
Personal Transportation?
Personal Transportation Available?
If yes, please enter license plate number:
CA Drivers License Number:
Automobile Insurance Carrier:
Languages
Fluent Languages (check all that apply)
If Other, enter below:

Section 2: Employment & Volunteer Experience

Employment Status
Current employment status
Please enter your 3 most recent Employment or Volunteer positions, beginning with current or most recent experience.
1. Company/Organization & Job Title
1. Dates of Employment/Volunteer Service
1. Company/Organization Address
Country
Address Line 1
City
State
Postal Code
1. Company/Organization Phone Number
1. Experience type
1. Reason for Leaving
Enter next most recent experience
2. Company/Organization & Job Title
2. Dates of Employment/Volunteer Service
2. Company/Organization Address
Country
Address Line 1
City
State
Postal Code
2. Company/Organization Phone Number
2. Experience type
2. Reason for Leaving
Enter next most recent experience
3. Company/Organization & Job Title
3. Dates of Employment/Volunteer Service
3. Company/Organization Address
Country
Address Line 1
City
State
Postal Code
3. Company/Organization Phone Number
3. Experience type
3. Reason for Leaving
Please describe duties, responsibilities and likes/dislikes about your past or present employment/volunteer experience(s):
What hobbies, sports, crafts or activities interest you?
Are you a member of any community service organizations or clubs? If so please list them:

Section 3: Education

Please select highest education level completed:
Enter all held degree(s) with corresponding major(s):
Last school attended & graduation date:
Are you currently attending school?
Do you have any special skills or licenses? If yes, please list:
Are there any personal, educational or work related constraints that may restrict your availability?
Other Experience
Do you have any experience in the following areas? Check all that apply.
If other, enter below:

Section 4: Personal References

Please list the names, addresses, and telephone numbers of 3 personal or professional NON-RELATIVE references whom we may contact. These references should be able to speak to your character, your reliability and have seen you interact with children.

First Reference

1. First & Last Name
1. Mailing Address
Country
Address Line 1
City
State
Postal Code
1. Phone Number
1. Relationship

Second Reference

2. First & Last Name
2. Mailing Address
Country
Address Line 1
City
State
Postal Code
2. Phone Number
2. Relationship

Third Reference

3. First & Last Name
3. Mailing Address
Country
Address Line 1
City
State
Postal Code
3. Phone Number
3. Relationship

Section 5: Background Information

1. Have you ever been arrested for a crime against a child?
2. Have you ever been arrested for a violent felony?
3. Have you ever been arrested for a sex crime?
If you answered "yes" to 1,2 or 3 above, can you produce a written declaration of a "Finding of Factual Innocence?"
Have you ever been convicted of any crime within the past 5 years?
(excluding vehicle code infractions, but including vehicular misdemeanors or felonies)
Have you ever been arrested or convicted of any crime not mentioned above?
Are you or have you been the subject of or been involved in a reporting to a Child Protective Agency?
Are you or have you been the subject of or been involved in an adjudicated dependent of any juvenile court?
Are you or have you been the subject of or been placed under informal supervision in any county's children's social service agency?
Have you ever been directly involved in a court proceeding in this or any other state?
As a child, were you or any of your siblings ever the subject of a child abuse report?
Are you currently paid or reimbursed to provide a service to children and/or parents within the child welfare and/or Juvenile Court System?

Note: Any applicant found to have been convicted of, or having charges pending for a felony or misdemeanor WILL NOT be accepted as a CASA Volunteer.

Section 6 : Medical Information

Are you currently under the care of a medical professional, and/or therapist and/or taking prescribed medications?
If you answered yes, please explain how it will or will not impact your role & duties as a CASA Volunteer:

Section 7 : Other

If you were to be accepted as a Volunteer with CASA of Merced County, do you agree to:
Be a CASA Volunteer until your case assignment is closed/resolved?
(Approximately 18 months, on average)
Complete the all CASA Training Classes, including daytime courtroom observation hours?
(30 hours of classroom training &10 hours of court observation)
Participate in ongoing supervision and training meetings?
Participate in court hearings when necessary?
(Approximately every 6 months)
Maintain confidentiality regarding all court cases and associated clients?
Submit to a criminal index and investigation background check?
(DMV, DOJ, FBI, CACI & Fingerprinting)
Provide verification of Automotive Liability Insurance before working directly with a child?
Volunteer 10 to 15 hours per month?
Work with children who have suffered abuse or neglect and their families?
Would you be willing to accept a sibling group assignment?
Are you willing to travel to maintain contact?
Are you willing to work with children of all ages?
I work best with children who are _____ (check all that apply)

Section 8 : Autobiography

Please write a one-page autobiography. (Approximately 500 words)
CASA VOLUNTEER ONLINE APPLICATION
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