Volunteer Application (49)

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Child Advocates of Montgomery County Texas Volunteer Application

Important: Before You Begin

This application can be submitted electronically at the end of the form. Be sure to press the SUBMIT button at the end. You will be asked for three references, including email addresses.

Instructions:

Please read the directions carefully and complete all sections of the application thoroughly.
We recommend preparing answers to the open-ended questions in advance to avoid losing your progress.

Thank you for taking the time to complete your CASA application! We look forward to receiving it.

CAPTCHA

Personal Information

Are you at least 21 years old?*

Yes

Name*

First Middle Last

Date of Birth*

MM slash DD slash YYYY

SSN*

Home Address*

Street Address Address Line 2 City State ZIP

Email*

Enter Email Confirm Email

Mobile Phone*

Home Phone

Work Phone

Preferred Phone Number*

Emergency Contact Name*

Include the phone number of someone we can contact on your behalf in case of an emergency. This should NOT be your own phone number.

Emergency Contact Phone Number*

Home Life

Have you lived outside of Texas with in the past seven years?*

Yes

If yes, please list the city and state so you have lived over the past seven years.*

Besides the spouse/partner and children you may have listed previously, are there any other members of your household?*

Yes

If yes, please give their names and ages, and the relationship to you.*

Background Information

Do you have any relevant work or volunteer experience with children?*

Yes

If yes, please describe.*

Please provide a brief autobiography which includes any historical information you feel shaped your life.*

Include information about your childhood, current lifestyle (career, family, hobbies, interests), and the reasons which led you to apply to volunteer with Child Advocates.

Have you ever been charged or convicted of a felony or a misdemeanor?*

Yes

If yes, please provide the date, offense/nature of charge or conviction, location, and the details and disposition of each charge.*

Are you currently under indictment or charged in an official criminal complaint accepted by a district or county attorney with a felony or misdemeanor?*

Yes

If yes, please provide the date, charges, location, and details for each charge.*

Drivers License #

Have you ever had your drivers license revoked or suspended?*

Yes

If yes, please explain.*

Child Advocates volunteers are expected to be able to transport themselves to court hearings, and other Child Advocates events (advanced notice is given.) Will access to reliable transportation pose any difficulties for you?*

Yes

If yes, please explain how you will overcome this obstacle.*

Personal References

Please list three personal references, including: First & Last Name, EMAIL address, and relationship to you. Family members or relatives CAN NOT be listed as references.

Reference 1 Name*

First Last

Relationship*

Phone*

Email*

Enter Email Confirm Email

Reference 2 Name*

First Last

Relationship*

Phone*

Email*

Enter Email Confirm Email

Reference 3 Name*

First Last

Relationship*

Phone*

Email*

Enter Email Confirm Email

Agreement

Are you willing to commit a minimum of a year to being a Child Advocates volunteer?*

Yes

Are you willing to complete Child Advocates' 35+ hour volunteer training program?*

Yes

Are you willing to participate in 12 hours of continuing education training yearly?*

Yes

Are you willing to visit in person at least monthly with the child(ren) to which you may be assigned?*

Yes

Are you willing to prepare written reports to the court with the guidance from Child Advocates staff?*

Yes

Are you willing to participate and attend court hearings and meetings on the child's case during regular business hours?*

Yes

Are you willing to record all your activities on your case?*

Yes

Release - Please read this release over and if you agree to the content below, please sign your electronic name below.

I certify that the information provided by me in this application is true and correct to the best of my knowledge and I agree to have any of my statements verified by Child Advocates of Montgomery CountyTexas unless I have indicated to the contrary. I certify that I understand that volunteer placement is a selection process and that not all applicants are accepted into the program. I understand that volunteers are selected based on individual ability to meet the responsibilities of the CASA Program. I also understand that because of the confidential nature of the screening process, Child Advocates of Montgomery County Texas Volunteer Application is not obligated to disclose to me reasons for any decision concerning my acceptance or non-acceptance into the program. Furthermore, I understand that Child Advocates of Montgomery County Texas has to consider the best interests of the children first when matching them with CASAs. Thus, I understand that the agency is not obligated to assign to me a child and that submission of this application in no way obligates me to perform volunteer services.

Certify*

I agree to and accept the terms and conditions above.

Name & Date