Please take a few moments to complete this pre screening application.
If you like to apply to become a CASA volunteer contact Debbie Gray, Volunteer Services Coordinator, at the CASA Office 757-926-3644 - dgray@nngov.com.

 
Your Name:  
Address:  
City:  
State:  
Zip:  
Home Phone #:  
Business Phone #:  
E-Mail:  
Date of Birth: (mm/dd/yr):  
Phone #:
 
    
 
Please answer the following:
I can be called at work.
Yes     No
I have a current driver's license.
Yes     No
I have regular access to a car.
Yes     No
I have automobile insurance.
Yes     No
I will be willing to participate in
on-going training and court appearances.
Yes     No
I understand I will be required to
complete CASA basic training.
Yes     No
I am aware that I will be committing a
minimum of one year to CASA.
Yes     No
Do you speak any languages other than English.
Yes     No
Have you had any personal experience involving teaching or child care? Yes     No
 
 
Please Give a brief statement on why you have chosen to work in CASA of Newport News at this time in your life:
 
 
I hereby certify that all statements made on this application are true and correct to the best of my knowledge.
I understand that by submitting this application I authorize inquiries to be made concerning my employment and character for the purpose of determining my suitability as a volunteer. I also understand that completion of CASA training does not ensure that I will be inducted or appointed as a CASA volunteer. I further understand that by my signature on this application, I authorize CASA of Newport News to complete record checks through the local and state police departments and the Department of Social Services Central Registry Desk. All information will be held in strictest confidence.
Having considered the opportunities and the responsibilities involved, I offer my services as a Court Appointed Special Advocate for the Juvenile and Domestic Relations Court and agree to follow all guidelines set forth by the Newport News CASA Program, including the maintenance of strict confidentiality about all information and knowledge acquired during my involvement with the program.
Criteria used in the selection of volunteers will be such as to insure that the individual is able to meet the responsibilities of a Court Appointed Special Advocate. No individual will be rejected because of race, color, religious creed, national origin, sex, age or marital status.
 
Signature (Type Your Full Name):  
 
Date (mm/dd/yr):  
 
  
  
   
   
The Newport News CASA program was created in 1985.  Newport News CASA is a 501 (c) (3), non-profit organization.

 
  CASA Volunteers are The Voice of the Children.
  The Newport News CASA program was created in 1985.  Newport News CASA is a 501 (c) (3), non-profit organization.
 
  Newport News CASA is part of the national network of 900 independent CASA programs.
  When abused children need help being heard, Newport News CASA is here to be their voice.