CASA of the Pines Volunteer Application

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Name (include nicknames and other names you’ve been known by)

Address No. of years at address?

City StateZipDate of Birth

Home PhoneWork Phone Cell Phone

Email:

Previous Address (include other states resided in during the past 5 years)

Are you employed: [ ]Yes [ ]No If Yes: [ ] Full-time [ ] Part-time

Place of EmploymentPosition

May you be called at work? [ ] Yes [ ] No

Social Security Number Marital StatusSpouse’s Name

Number of Children[ ]Children’s Ages:

Education: (Circle or Bracket highest completed)

High School: 9 10 11 12 College: 1 2 3 4 Graduate: 1 2 3 4

MajorDegree

Do you speak a foreign language? [ ]Yes [ ] No If Yes, which language?

Do you drive a car? [ ] Yes [ ] No Do you have regular access to a car? [ ] Yes [ ] No

Texas Driver’s License Number

Do you have current automobile insurance?[ ] Yes[ ] No

Current community activities:

List current and previous volunteer work (list all previous volunteer work including brief description of duties and activities, dates of service):

As a CASA volunteer you will be required to attend court hearings for the children you represent. Will you be able to arrange your schedule to attend these hearings?

[ ] Yes [ ] No

Are you willing to commit to one year of volunteer services? [ ] Yes [ ] No

What are your reasons for wanting to participate as a CASA volunteer?

Do you have any training or experience in any of the following (check all that apply):

Child Welfare / Fundraising / Advertising
Court System / Social Work / Education
Child Care / Law Enforcement
Counseling / Media

If so, please explain:

How did you learn of our program?

Note: 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 that would pose risk to children or the CASA Program’s credibility is not accepted as a CASA volunteer.

Have you ever been convicted of a crime other than a traffic violation? [ ] Yes [ ]No

If yes, on what charge? Date convicted Where?(City, County, State)

Do you consent to a routine check of your criminal records? [ ] Yes [ ] No

Can you think of any reason why a judge might be reluctant for you to serve as a CASA volunteer?

Are you prepared to complete 30 hours of pre-service training and a minimum of 12 hours per year of in-service training? [ ] Yes [ ] No

PERSONAL REFERENCES: (Please list 4, only one may be a relative). One reference must be a current or former employer or volunteer supervisor.

PLEASE PRINT

NameAddress or Email Address

City, State ZipTelephone Number

Relationship:

NameAddress or Email Address

City, State ZipTelephone Number

Relationship:

NameAddress or Email Address

City, State, ZipTelephone Number

Relationship:

Employer or volunteer supervisor reference (mandatory)

NameAddress or Email Address

City, State, ZipTelephone Number

How long have you lived in the area?

CASA of the Pines reserves the right to make any checks deemed appropriate as to the suitability of anyone responsible for this confidential work. All information obtained will be held in the strictest confidence.

Applicant’s SignatureDate

APPLICATION RELEASE

I, , hereby affirm that all of the answers provided on my volunteer application are true. I hereby authorize the CASA of the Pines program to investigate my background to determine my fitness as a potential volunteer. This includes contacting references provided by me, conducting a criminal background check, a child abuse registry check through the Texas Department of Protective and Regulatory Services, and a sex offender registry check.

I understand that the information requested in this application will be used only for the purpose of determining suitability as a CASA volunteer. Further, I understand that after the successful completion of my training, I will be expected to serve a minimum of one year in the CASA program. The first six months of my participation in the CASA program will be considered probationary.

I am aware of the sensitive and confidential nature of the official documents, reports and other material I will examine in my capacity as a 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 further understand that knowledge gained through volunteer service at CASA of The Pines may not be used for personal profit, profit for friends or family, to obtain a child for adoption, or for any other personal gain or benefit.

CASA of the Pines policies and CASA standards including those in the CASA volunteer management policy must be honored. CASA staff members may issue additional, reasonable volunteer work rules, if such are required.

I understand that falsification of any information hereby given will invalidate my participation with CASA of the Pines.

CASA of the Pines will not discriminate with regard to race, color, religious creed, national origin, sex, age or marital status.

______

Signature Date
Please answer the following questions:

  1. Write a short summary about your interest in volunteering and how you hope to benefit from the volunteer experience.
  1. Briefly explain what led to your decision to apply for a position in the CASA program? (What attracted you to this particular program?)
  1. Briefly explain your philosophy of parenting, including the rights and responsibilities of both parents and children.
  1. Please write a short autobiography.

Please mail to:

CASA of the Pines

PO Box 835

Lufkin, Texas 75902

CASA OF THE PINES

VOLUNTEER ADVOCATE JOB DESCRIPTION

Purpose of the Position:

  • To recommend to the court, based on fact-finding and investigation, the “best interest” of a child in the conservatorship of the Department of Protective and Regulatory Services, or a juvenile involved in the court system.
  • To believe that every child has a right to a safe, permanent home that meets that child’s basic needs.
  • To provide support, assistance, and advocacy to assure permanency for children.

Responsibilities of the Position:

  • Interview all parties, clients and professionals involved with the assigned case.
  • Maintain records of all findings. Maintain precise case notes. Return all case records and notes at the conclusion of the assigned case.
  • Confer with CASA Supervisor on a regular basis-no less than twice each month-prior to any hearing.
  • Attend all staffing on an assigned case concerning the child/children.
  • Meet with the child/children involved with the case at least monthly
  • Prepare written court reports for Review Hearings.
  • Appear in court to represent the child’s best interest.
  • Monitor the case to ensure court orders are being followed, and appropriate services are being provided for the child and parents in a timely manner.
  • Investigate and monitor a child’s placement-residential treatment facility, group home, foster home, or relative placement. Determine suitability of placement.
  • Advocate for permanency. If parental rights are terminated, remain on the case until the child is placed in an adoptive home and the adoption is consummated.
  • Accept/request support resources from CASA staff.
  • Return statistical forms monthly.

______

SignatureDate

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