CASA NYC

Contact Information

Full Name (required)

Your Email (required)

Home Address (required)

City (required)

State (required)

Zip (required)

Home Phone (required)

Company Name

Work Address

City

State

Zip

Work Phone

Basic Questions

How long have you lived in the NYC area? (required)

Where else have you lived? (required)

May we call you at work?
 Yes No

Diversity

CASA is dedicated to developing a diverse volunteer population. Please help us track our progress by providing the following information.

Date of Birth (required)

Gender
 Male Female

Ethnicity
 Asian Black Hispanic White Mixed Other Unknown

Work
 Full-time Part-time Self-Employed Retired Student Not working

How Did You Hear About Us?
 Brochure Friend/CASA Volunteer TV/Radio Volunteer Referral Organization Work Other Website

Education

List the schools you''ve attended, fields of study, degree held and the date you completed studies (required)

Computer skills?
 Yes No

Do you speak any languages other than English? If yes, which ones:

Youth, Legal System or Other Related Experiences (Volunteer or Paid)

Please list dates, organizations worked with, positions held at those organization, and duties performed.

CASA-NYC is a volunteer program that works with children in the foster care system. The New York State court system requires that volunteers provide us with this information.

List below any convictions for violations of law (other than traffic violations) in this state or elsewhere and all charges currently pending anywhere. If none, please state "NONE." (required)

Have you ever been the subject of a child abuse or neglect investigation? (required)

Within the past year, have you used Methadone, even if prescribed by a physician? (required)

If "yes", please indicate whether part of a treatment program. If so, give name of program/physician and other services received. You will be asked to submit a doctor''s report describing your treatment program and diagnosis.

CASA-NYC will reject 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 risks to children or the CASA-NYC program''s credibility.

In case of Emergency, Contact

Name (required)

Relationship (required)

Phone (required)

References

Please list the names and addresses of three people who can serve as character references. You must include your job supervisor (if applicable). Put Name, Relationship to you, Address and Phone Information

You may not use relatives or significant others.

Reference 1:

Reference 2:

Reference 3:

Affirmation

Are you confident you can commit to spending at least one year as a CASA advocate on a regularly scheduled basis? (required)

If accepted, will you be able to meet the CASA requirement for regular supervisory meetings? (required)

New York City CASA reserves the right to make any checks deemed appropriate as to the suitability of anyone responsible for this confidential work. Criteria used in the selection of volunteers will be such as to insure that the applicant is able to meet the responsibilities of a volunteer as a Court Appointed Special Advocate. No individual will be rejected on the basis of race, color, national origin, religion, sex, marital status, sexual preference, age, veteran status or disability.

Application Statement (incomplete applications will not be considered)

Please type 3,500 characters or less describing the following:

• what made you decide to apply to become a CASA volunteer advocate
• what attracted you to the program
• your interest in volunteering
• three concerns you have regarding the rights of children and families
• what you feel you can contribute to the program
• how you hope to benefit from the volunteer experience

Please upload a copy of your resume in PDF, TXT, DOC or DOCX format:

I understand that by submitting this application, I authorize CASA to make inquiries regarding my suitability to become a volunteer advocate and that CASA will use the information in this application and information obtained through other sources for the purpose of determining my suitability as a volunteer advocate. I also understand that all information obtained will be held in the strictest confidence. I acknowledge that this application becomes the property of CASA. All of the information I provided is accurate and subject to verification by CASA. I acknowledge that in the event of the agency''s determination of my ineligibility in accordance with longstanding agency policy, the reason will not be provided.

(If you click submit and nothing happens, scroll down a little and there should be a message explaining what went wrong.)