Volunteer Guardian Application
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7Volunteer Guardian Application:
While this application may seem extensive, the court requires much of the information
requested. It will be kept confidential. Our guardians do not handle money. They monitor
medical care and quality of life and make decisions related to these areas.
Note: Use mouse to move to each new field when filling in with computer tab feature and
enter will not work.
Name:
Address:
City:
State:
OH
Zip Code:
Cell Phone:
Work Phone:
Home Phone :
Email:
Are you over 21?
Date of Birth
Social Security #:
Occupation:
Spouse, if any: (Court asks this on forms): If no spouse, list emergency contact:
Name:
Month/Year Married:
Cell Phone:
Home Phone
1.
How did you learn of the Volunteer Guardian Program?
2.
Why do you want to serve as a guardian for someone with a disability?
3. Are you presently serving as a guardian, or representative payee?
Yes
No
If yes, describe:
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