Volunteer Application

Boston CASA Volunteer Application
Date *

Month Day Year
Date
How did you learn about Boston CASA?
Full Name *

First Name Middle Name Last Name
Date of Birth *

Month Day Year
Date
Preferred Phone *

Area Code Phone Number
Preferred Phone Type
Other Phone

Area Code Phone Number
Other Phone Type

Address *

Street Address
Street Address Line 2
City	State
Zip Code	Country

E-mail *
Employer/School
Occupation/Field of Study
Does your employer have a matching gift program? *
Emergency Contact: *
Relationship: *
Emergency Contact Phone: *
Are you Bi-lingual? If yes, please list language(s) below:
Professional Licenses/Certifications
Educational Background
Employment Status
I Identify my gender as: *

Female Male Genderqueer/Non-Binary Prefer not to Disclose
Do you identify as a member of the LGBTQ+ community? *

Yes No Prefer not to Disclose
Are you Hispanic or Latino? *

Yes No Prefer not to Disclose
How do you identify? *

American Indian or Alaska Native Asian Black or African American Native Hawaiian or other Pacific Islander White Prefer not to Disclose
Have you had any professional and/or personal experience involving the following? (we will discuss further in the interview)

Court System Child Welfare Foster Care Child Care
Have you lived outside of Massachusetts? If yes, please tell us where:
Indicate your availability (please check all that apply): *

Monday am Monday pm Tuesday am Tuesday pm Wednesday am Wednesday pm Thursday am Thursday pm Friday am Friday pm Saturday am Saturday pm Sunday am Sunday pm
Work Experience (if you prefer, you may submit a resume to adriana@bostoncasa.org):
Please list current & previous volunteer experience (including past experience with the CASA program):
Why are you interested in volunteering as a CASA (Guardian ad Litem)? *
Do you have any reservations about becoming a CASA volunteer that you would like to share with us? *
What motivates you to want to volunteer for Boston CASA? What do you expect to gain from this experience? What do you believe you will bring to the program? *
The children served by Boston CASA have experienced abuse or neglect most often due to a combination of factors such as parental mental illness, domestic violence, substance abuse, and poverty. As much as you are willing to share, describe your personal or professional experience with these various issues. How do you expect that your experience, or lack thereof, will influence you as a CASA? *
Please list two people below who can provide a reference for you. One reference needs to be a current or past supervisor and the other a colleague or friend (but not a family member).
Name *
Email Address *
Name *
Email Address *
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:

Clear
Today's Date: *

Month Day Year
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: *

Female Male Genderqueer/Non-Binary Prefer not to Disclose
How do you identify? *

American Indian or Alaska Native Asian Black or African American Native Hawaiian or other Pacific Islander White Prefer not to Disclose
Should be Empty:

Boston CASA Volunteer Application