Casa Volunteer Application Form Page 4
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5Volunteer App w/Releases & Affirmation
Are you willing to commit to one year of volunteer service? ____ Yes ____ No
How many hours per week are you available? __________
As a CASA Volunteer you will be required to attend court hearings for the children you represent.
Will you be able to arrange your schedule to attend these hearings? ____ Yes ____ No
Do you drive? ____ Yes ____ No
Do you have access to a car? ____ Yes ____ No
Driver’s License Number: State _____ Number ____________ (Please provide a copy of your license.)
REFERENCES
Please provide three names to be used as Professional References. You should know these individuals for
at least one year. Two of the references you should know professionally through your work, volunteer
service, or academics. One may be a personal reference, excluding a family member. Completed Written
Reference Forms must be returned to the CASA office PRIOR to being sworn in.
Three References:
Name: _____________________________________________________________
Address: ____________________________________________________________
Phone: ___________________ Relationship: _____________________________
Name: _____________________________________________________________
Address: ____________________________________________________________
Phone: ___________________ Relationship: _____________________________
Name: _____________________________________________________________
Address: ____________________________________________________________
Phone: ___________________ Relationship: _____________________________
PLEASE WRITE A SHORT AUTOBIOGRAPHY (1 page or less).
WVCASA Mandatory State Standard I.A. Form
Page 4 of 5
2.2009
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