Alcovy CASA Application

Have you ever been arrested? *

Yes No
If yes, please explain below. A conviction does not necessarily disqualify you from the volunteer program. However, CASA will automatically reject 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 what would pose risks to children or the CASA program's credibility. If this does not apply, put N/A. *
Have you ever had a DUI/DWI? *

Yes No
If yes, please explain.
Have you ever had an addiction to drugs and/or alcohol? *

Yes No
If yes, please explain
Have you ever had a case with or investigation performed by the Department of Family and Children Services? *

Yes No
If yes, please explain below: If this does not apply, put N/A. *

Are you prepared to complete 40 hours of pre-service training; and 12 hour per year of in-service training? *

Yes No
Are you able to commit to attending all court hearings, once assigned to a CASA case? *

Yes No
Are you able to commit to visiting the case you are assigned monthly? *

Yes No
Why do you want to volunteer in the community, specifically with CASA? *
Is your family supportive of you becoming a CASA volunteer?
What values are important to you, and why? *

How would you describe yourself? Name strengths and areas for improvement. *
What kind of situations do you find stressful? How do you deal with that stress? *
Why do you think that children come into foster care? *
How would you handle interacting with a parent who has abused/neglected their child? *
What type of work environments/management style do you prefer? Why? *

Is there anything else that you would like to tell us about yourself?
REFERENCES: Please list three references of people, unrelated to you by blood or marriage, who know you through either a paid or volunteer capacity. A link will be sent via email. Please remind references to check spam folders as well.
Reference #1 Name: *
Reference #1 Relationship to you: *
Reference #1 Email Address *
Reference #1 Telephone Number
Reference #2 Name: *
Reference #2 Relationship to you: *
Reference #2 Email Address *
Reference #2 Telephone Number
Reference #3 Name: *
Reference #3 Relationship to you: *
Reference #3 Email Address *
Reference #3 Complete Mailing Address (Only if an email was not provided)
Reference #3 Telephone Number:
Write a brief statement on why you have chosen to work with the CASA program at this particular time in your life? *

I hereby affirm that all of the answers provided on my volunteer application are true and accurate. I hereby authorize Alcovy CASA, Inc., and any law enforcement agency CASA authorizes to investigate my background to determine my fitness as a potential volunteer.

I further understand that the information requested in this application will be used only for the purpose of determining my suitability as a CASA volunteer. I understand that the completion of this application does not guarantee that I will be chosen for the training class.
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Alcovy CASA, Inc. Volunteer Application