Volunteer Application (0848)

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CASA of the Tennessee Heartland 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.
Have your education, work, and volunteer history handy. You will also have the option to upload a PDF of your résumé.
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

Qualifications & Personal Information

Are you at least 21 years old?*

Yes

Name*

First Middle Last

Gender*

Female

Male

Other

Race

This information is collected solely for reporting purposes and is not used in evaluating your application. Your response is optional.

Date of Birth*

MM slash DD slash YYYY

Home Address*

Street Address Address Line 2 City State ZIP

Home/Work Email*

Enter Email Confirm Email

Mobile Phone*

Home Phone

Work Phone

Preferred Phone Number*

Times Easily Reached*

Example: 8:30am

Primary Language*

What languages do you speak other than English?*

Please specify. If none, write "not applicable." To skip this question, write "I decline to respond."

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*

Employment/Career

What is your highest level of education?*

GED

High School

College

Some College

Post-Graduate

Vocational Training

Other

Current/Most Recent Employer

Career Type*

Education

Legal

Medical

Social Work

Government/Military

Business/Financial

Other

Check all that apply.

Background Information

Please tell us how you heard about CASA of the TN Heartland*

Please tell us any experience you have with community and volunteer organizations.*

Do you have any specialty training, licenses or certifications?*

Yes

If yes, please list them.*

Do you have any hobbies and/or special interests?*

Yes

If yes, please list them.*

Please describe any previous or current involvement you have with a court (Juvenile or other) or any child custody case.*

Describe your experience working with children as a volunteer or professionally.*

Why have you chosen to work with the CASA program?*

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 prepared to complete 33 hours of pre-service mandatory training and 12 hours of continuing education each year?*

Yes

Can you commit a minimum of 2 years to our program?*

Yes

CASA volunteers are expected to be able to transport themselves to court hearings, and other CASA events. Do you have access to reliable transportation?*

Yes

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

By submitting this application electronically, I hereby affirm that all of the information provided on this application is true. I understand that if any statement I have made is found to be false, I will be denied a position as a Court Appointed Special Advocate or, if already accepted, terminated from my CASA volunteer position. I authorize CASA of the Tennessee Heartland, and any law enforcement agency they authorize, to investigate my background to determine my fitness as a potential volunteer. I authorize CASA to procure a National Background Check including a check of the National Sex Offender Registry, driver’s license verification and social security verification. I agree to notify CASA of any incidents, charges and arrests that may occur after it is determined that I am a suitable volunteer. CASA will maintain all background check information to preserve confidentiality.

I understand that in accordance with National CASA and Tennessee CASA standards, CASA of the Tennessee Heartland will reject any applicant found to have been charged with, 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. This would also include a pending Department of Children’s Services investigation.

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 the training does not guarantee that I will be appointed to 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 two years (or the completion of a case, whichever is greater) with the program. If unforeseen circumstances prevent me from fulfilling this obligation, I will submit my written resignation to the Program Director with as much notice as possible. I am aware of the sensitive and confidential nature of this work, 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, or for any other reason deemed sufficient by CASA, my services as a CASA volunteer may be terminated at the complete discretion of CASA. Representation as a volunteer advocate for CASA of the Tennessee Heartland is, and remains, at the sole discretion of the CASA board of directors at all times.

Certify*

I agree to and accept the terms and conditions above.

Name & Date