CASA for Clermont Kids! Volunteer Application
This application is for all who wish to serve CASA for Clermont Kids (regardless of whether you are a desired CASA/GAL volunteer, Board Member or intern). 

Please fill out the application completely and we will be in contact shortly over your application.

Want a crash course on being a CASA volunteer for CASA for Clermont Kids first? Check it out here
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Email *
First and Last Name *
What volunteer experience are you applying for today? *
Phone Number *
Are you at least 21 years old? *
What is your date of birth? *
Are you a U.S citizen? *
What is your race/ethnicity (ies)? Click all that apply *
Please indicate your gender(s). Select all that apply. *
What is your ethnic origin? Select best option *
Home Address *
How long have you been at current address? *
Previous Address if you have moved in the last seven years
Who all lives in your household and what is their relationship to you? *
Current Employment Status: *
Name of Employer and Address
Highest Level of Education: Name of school, Degree completed, major/field of study *
Any volunteer or job related experience dealing with youth, juvenile justice system, etc. ? *
Are you presently a volunteer in any capacity? If yes, indicate position, agency, amount of hours committed monthly. *
List any specific skills/qualifications that you have that would be of value to CASA. *
How did you learn about the CASA program? *
Have you ever applied/or were you ever a CASA volunteer in any capacity before? *
If yes, where?
Do you have any current or prior history with any Child Protective Service Agency? *
If yes, explain?
Do you have any past experiences, personally or professionally, with DJFS or any juvenile court system? *
If yes, explain?
Do you speak a second language? *
If so, which one?
Do you have a valid driver's license?
Clear selection
Do you carry active car insurance?
Clear selection
Have you ever been convicted of a crime in a court of law? *
If yes, explain?
Please write a short summary about your interest in volunteering for CASA for Clermont Kids! *
Please provide name, phone and email of three references for you. Please alert your references that we will be in contact with them. References should not be family members.
Reference #1 Name *
Reference #1 Phone Number *
Reference #1 Email *
Reference #1 Relationship to you *
Reference #1 How long have you known them? *
Reference #2 Name *
Reference #2 Phone *
Reference #2 Email *
Reference #2 Relationship to you *
Reference #2 How long have you known them? *
Reference #3 Name *
Reference #3 Phone *
Reference #3 Email *
Reference #3 Relationship to you *
Reference #3 How long have you known them? *
You understand that by submitting this application, you are granting us permission to request information from and share information with other CASA/GAL Programs.  You are also acknowledging that you understand that all information on this application will be verified by CASA for Clermont Kids to decide your suitability to serve as a volunteer—including, but not limited to, employment; past criminal history; involvement with Child Protective Services or the Juvenile Court; previous CASA contacts, and current volunteer activity.

By submitting this application, you certify that you are aware that there may be some circumstances that may not allow you to be eligible to participate in the program at this time including but not limited to nature and disposition of certain criminal offenses; certain types of involvement with Child Protective Services and current and recent matters being heard in the Juvenile Court.

The CASA program will reject any applicant found to have been convicted or, 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.

By submitting this application, you certify that the information contained in this application is true and accurate to the best of your knowledge.
A copy of your responses will be emailed to the address you provided.
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