Volunteer Application

Boston CASA Multicultural Advisory Committee Application
What volunteer position are you applying for?
Date*

MonthDayYear
Date
How did you learn about Boston CASA?
Full Name*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Date
Preferred Phone*

Area CodePhone Number
Preferred Phone Type
Other Phone

Area CodePhone Number
Other Phone Type
Address*

Street Address

Street Address Line 2

CityState

Zip Code
E-mail*
Occupation/Field of Study*
Emergency Contact:*
Relationship:*
Emergency Contact Phone:
Area Code
Emergency Contact Phone*

Area CodePhone Number
Are you Bi-lingual? If yes, please list language(s) below:
I Identify my gender as: (This information is gathered for internal use only and is intended to be used for funding and other reporting requirements)*

FemaleMaleGenderqueer/Non-BinaryPrefer not to DiscloseTransgenderOther
Do you identify as a member of the LGBTQ+ community? (This information will be confidential and used for funding data reporting)*

YesNoPrefer not to Disclose
Are you Hispanic or Latino? (This information will be confidential and used for funding data reporting)*

YesNoPrefer not to Disclose
How do you identify? (This information will be confidential and used for funding data reporting)*

American Indian or Alaska NativeAsianBlack or African AmericanNative Hawaiian or other Pacific IslanderWhitePrefer not to DiscloseOther
Have you had any professional and/or personal experience involving the following?

Court SystemChild WelfareFoster CareChild Care
Please describe any community connections/ties you may have
Please describe any experience with community organization, engagement or outreach. If you do not have any experience with these, what prompted your interest in joining this committee? *
Please describe your experience working with people from under-served populations and give an example that highlights a success collaborating with this community. *
What motivates you to want to be part of this committee for Boston CASA? What do you expect to gain from this experience? What do you believe you will bring to this committee?*
MAC Meetings will be held during the months of February, April, July, and October 2025. Please indicate below the days and times that would work best for you (choosing the day(s) that work best and timeframe.*

MondaysTuesdaysWednesdaysThursdaysFridaysLunch time: 1PM-2PMEvening time: 5PM-6PMEvening time: 6PM-7PM
To the best of my knowledge the above information is true and is submitted voluntarily. This information may be used and disclosed for Boston CASA purposes and I realize that as a CASA Volunteer, I will not be paid for my service. I am aware that Boston CASA has the right to release me from service at any time, just as I have the right to withdraw from volunteer service at any time.
Signature:
Today's Date:*

MonthDayYear
Date
At Boston CASA, we don’t just accept difference - we celebrate it, support it, and thrive on it for the benefit of our team and the communities we serve. Boston CASA is an equal opportunity employer and as such, we do not discriminate against any team member or candidate because of race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy, or any other basis protected by law. We encourage all to apply because we believe a diversity of voices leads to better discussions, decisions, and outcomes for everyone.
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I Identify my gender as:

FemaleMaleGenderqueer/Non-BinaryPrefer not to DiscloseOther
How do you identify?

American Indian or Alaska NativeAsianBlack or African AmericanNative Hawaiian or other Pacific IslanderWhitePrefer not to Disclose
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Boston CASA Multicultural Advisory Committee Application