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Basic Information
Address

Please provide the name, age, and relationship of each person that lives in your household

Contact Information
Drivers License Info

All CASA Volunteers must have a valid driver's license and current automobile liability insurance. Volunteers must provide the CASA office with a copy of the most up-to-date liability insurance and a current driver's license in order to process your application

Auto Insurance Information
Education Info
Employment Information
Current Job Information
Military Information
Volunteer Experience
Training Information

Successful completion of 30 hours of initial training is required prior to acceptance into the CASA program.

Please check all that apply

Emergency Contact Info
Personal References

Please list three (3) personal references. One must be employer or co-worker if employed. Teachers, ministers, volunteer supervisors or similar may be used in place of employer if unemployed. Please do not list relatives. All references will be mailed a questionnaire to complete. Application approval is pending receipt of at least three returned references.

Reference #1
Reference #2
Reference #3
Background Information

Have you ever been:

Have you ever been: Yes No
Arrested for a crime against a child?
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