CASA of Will County: Volunteer Application

How do I apply to become a CASA?
Individuals may apply to serve as advocates for the CASA/GAL program by submitting a written application provided by the office or completing an online submission form. Requests for the names and addresses of three references will be required. Applicants are screened by CASA staff and selected individuals will be asked to schedule an interview.

In addition to completing the form below, please download the background check authorization form. After signing this form please fax (815-730-7073) or mail it to us. You may also download the application form and complete it offline.

Personal Information

Name:*

Address:

City:

State:

Zip:

Date of Birth:

Home Phone:

Work Phone:

Cell Phone:

Email:*

Emergency Phone:

Emergency Contact:

Sex:

Male

Female

Ethnicity:

African American

Native American

Asian American

Caucasian

Latino

Other

Employment Experience

Employer:

Position:

Address:

City:

State:

Zip:

Employment Status:

Full Time

Part Time

Student

Not Employed

Retired

How long have you worked at present job?

Driver's License #

State:

Expires:

Referred to program by:

Flier/poster	Internet	Radio	Friend	Newspaper
Volunteer Referral Program	National CASA	National Media	Other

Background Information

Educational Background:

GED

High School

Some College

College

Post Graduate

Other

Are you willing to consent to a criminal records check?

Yes

Have you ever been convicted for any criminal charges or serious traffic charges?

Yes

If yes, please give details:

Date of Offense:

Age at that time:

Charge:

City:

State:

Do you have any criminal charges pending at present?

Yes

If yes, please explain:

Please list three (3) non related local references complete mailing ADDRESS (house #, street, city ZIP code, email address, and telephone number. References will be verified.

Reference Name:

Address:

City:

State:

Zip:

Telephone:

Email:

Reference Name:

Address:

City:

State:

Zip:

Telephone:

Email:

Reference Name:

Address:

City:

State:

Zip:

Telephone:

Email:

Personal Experience

Primary Language:

English

Spanish

Signing

Any additional languages spoken?

Have you ever had any personal experience involving:

Child Welfare	Foster Care	Juvenile Court System
Oher Child Welfare Agencies

If so, please explain:

List any previous or current volunteer experience:

List experiences, skills, and strengths that would make you an effective CASA:

Write a brief statement on why you want to work with the CASA Program

Can you complete 30 hours of CASA training?

Yes

We ask all applicants to make a commitment of two (2) years. Can you make that commitment?

Yes

Do you have some flexibility in your daily schedule?

Yes

Describe any personal or professional constraints that may restrict your time: