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Application

Become A Volunteer

Court Appointed Special Advocate Program Volunteer Application Utah Office of Guardian ad Litem and CASA

For a downloadable copy, please click HERE. Please return this completed application by email or mail to the Program Coordinator in your area.

PLEASE COMPLETE THIS FORM IN ITS ENTIRETY SO THAT WE MAY PROCESS YOUR APPLICATION. THANK YOU!

Application for Volunteer CASA Program
First Name *
Last Name *
Month
/
Day
/
Year
Country
Address Line 1 *
City *
State/Province *
Postal Code *
Country
Address Line 1
City
State/Province
Postal Code
Employment Information
Employment status
Education Information
Driver Information
Valid Driver’s License:
Access to Insured Vehicle:
List current and previous volunteer or community activities:
Do you have any training or experience in any of the following areas?
Are you willing to commit to one year with CASA?
Personal History
Have you ever been a victim of abuse?
Have you ever been convicted of a crime? (Exclude minor traffic violations.)
Do you consent to a yearly review of your criminal records?
Do you consent to a yearly review by the Department of Child and Family Services?
References

(please refrain from using immediate family members)
CASA Program Coordinator will email forms to your references

First Name *
Last Name *
First Name *
Last Name *
First Name *
Last Name *
AFFIRMATION AND RELEASE

I, the undersigned, hereby affirm that all of the answers provided on my volunteer application are true. I hereby authorize the CASA/GAL program to investigate my background to determine my fitness as a potential volunteer.

I understand that the information requested in this application will be used only for the purpose of determining suitability as a CASA/GAL volunteer. If unforeseen circumstances prevent me from fulfilling this obligation, I will submit my written resignation to the CASA coordinator with as much advance notice as possible.

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 Court Appointed Special Advocate. 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 understand any breach of confidentiality could result in my dismissal as a CASA.

First Name *
Last Name *
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