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Introduction

Intro
Thank you for taking this important step towards helping to Change a Child's Story™ .

Please consider using the 'Sign In to Save Progress' button at the upper right of this form.

Once you have submitted this form, a member of the CASA staff will contact you within 2 business days.

All written notes, documentation and materials associated with your application and interview process are Snohomish County public records and may be subject to disclosure pursuant to the State of Washington’s Public Records Act (RCW 42.56).
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Applicant Information

First Name
Last Name
Middle Initial
Preferred/Chosen Name
Pronouns:
1. She/Her/Hers
2. He/Him/His
1. They/Them/Theirs
2. I don't use pronouns (please use my name)
1. I use other pronouns
If your pronouns are not listed above, please write in here:
Address
Address2
City
State
Zip
Phone
Email
Date of Birth
Date of Birth
For which training session are you applying?
Please list any languages you speak fluently, in addition to English.
Do you hold a valid Washington State Driver's License?
Do you have vehicle insurance?
Do you have convenient access to a car/transportation?
Do you have any restrictions on your ability or willingness to drive?
Restrictions on Driving
Driver's License
Please upload an image of your driver's license.
Insurance
Please upload an image of your auto insurance.
How did you hear about the Office of the Court Appointed Special Advocate?
Where did you hear about the Office of the Court Appointed Special Advocate.
Please explain more about how you heard about the Office of the Court Appointed Special Advocate
Have you ever volunteered for a CASA or child advocate program?
If yes, where and when?
Have you ever been charged with a crime?
Answering yes does not automatically disqualify applicants.
If yes, please explain:
Have you ever been convicted of a crime?
Answering yes does not automatically disqualify applicants.
If yes, please explain:
Have you ever worked for any juvenile court system?
Have you ever worked for the Department of Children, Youth, and Families?
Have you ever been a foster parent?
Are you currently a foster parent?
In which county are you a foster parent?
Do you have a current or past case filed against you in dependency court?
A past dependency case does not automatically disqualify applicants.
In which county and when was your dependency case open?
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Identity

Specialized Experience

Education

High School / GED Diploma
A high school diploma or GED Equivalency is required to volunteer as a Court Appointed Special Advocate.
Post Secondary (vocational, college, university) Name:
From:
From:
To:
To:
Did you graduate?
1. Yes
2. No
Degree:
Are you still attending school?
1. Yes
1. No
How often?
Would you like to add another Post Secondary (vocational, college, university)?
Post Secondary (vocational, college, university) Name:
From
From
To:
To:
Did you graduate?
1. Yes
2. No
Degree:
Would you like to add another Post Secondary (vocational, college, university)?
Post Secondary (vocational, college, university) Name:
From
From
To:
To:
Did you graduate?
1. Yes
2. No
Degree
Additional space for information regarding your education.
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References

Please list three references who are unrelated to the applicant.
Reference 1
Full Name
Relationship*
Address
Address2
City
State
Zip
Reference 1 Phone Number
Reference 1 Email *
Reference 2
Full Name
Relationship*
Address
Address2
City
State
Zip
Reference 2 Phone Number
Reference 2 Email*
Reference 3
Full Name
Relationship*
Address
Address2
City
State
Zip
Reference 3 Phone Number
Reference 3 Email*
Reference 4
Full Name
Relationship
Address2
City
State
Zip Code
Reference 4 Phone Number
Reference 4 Email
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Employment Experience

Current Employment Status:
1. Full Time
2. Part Time
1. Retired
2. Student
1. Unemployed
Company
Address
Address2
City
State
Zip
Responsibilities
Dates
Dates Start Date
—
Dates End Date
Reason For Leaving
Company
Address
Address2
City
State
Zip
Responsibilities
Dates
Dates Start Date
—
Dates End Date
Reason for Leaving
Additional Space for Employment Information
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Volunteer Experience

Have you ever been asked to leave a volunteer position?
Why were you asked to leave?
Please list all volunteer activities for the past ten years.
Organization
Dates
Dates Start Date
—
Dates End Date
Responsibilities
Reason for leaving
Organization
Dates
Dates Start Date
—
Dates End Date
Responsibilities
Reason for leaving
Space to list additional volunteer experience.
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Supplemental Questions

Why do you want to serve as a Court Appointed Special Advocate?
What specific skills, education, and/or lived experience do you possess that would make you an outstanding volunteer?
Describe some opportunities you have had to work in diverse, multicultural, and inclusive settings. This may include times you worked with people of different races, cultural backgrounds, gender/sexual orientations and expressions, disabilities, or economic status. Please explain how that experience will contribute in your role as a CASA volunteer.
CASAs need to be able to utilize MS Office Suite to write reports (MS Word, SharePoint, or Office 365), organize calendar events and manage several email folders (MS Outlook). What is your skill level and experience utilizing MS Office Suite? What areas, if any, do you need further training and are you willing to seek out this training in order to utilize the software?
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Disclaimer and Signature

I understand that by submitting this application, I authorize inquiries to be made concerning my suitability as a volunteer. I further acknowledge that my service as a volunteer is an at-will appointment and may be terminated by the Office of the Court Appointed Special Advocate at any time.

Criteria used in the selection of volunteers will be such as to insure the individual is able to meet the responsibilities of a volunteer Court Appointed Special Advocate. No individuals will be rejected because of race, color, creed, religion, sex, sexual orientation, gender identity, gender expression, age, disability, ancestry, national origin, or marital status/civic union or domestic partnership status.

Completion of application, interview, and preservice training process does not guarantee acceptance into the program.

I certify that my answers are true and complete to the best of my knowledge.
If this application leads to a volunteer position, I understand that false or misleading information in my application or interview may result in my release.
I Understand and Agree*
1. Yes
1. No
Electronic Signature*
Date*
Date
Place*

Leave This Blank:

1. Receive an email copy of this form.
Email address

This field is not part of the form submission.
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Application

Steps

Introduction

Applicant Information

Identity

Specialized Experience

Education

References

Employment Experience

Volunteer Experience

Supplemental Questions

Disclaimer and Signature