Download Volunteer Application

PARACHUTE CASA Volunteer Application

Errors were found with your application. Please fix the items marked below and resubmit.

* = Required Field

Personal Information

Please provide your name.


Please provide your present address.

  

Please provide the dates you have been at your present address.



  


Please provide your home phone number.

Please provide your email address. Please enter a valid email address.

Please provide your age.

Please provide your date of birth.


Please tell us how you heard about PARACHUTE.


Please provide an emergency contact.


Employment Information

Please pick one.


Education


Please provide your highest education level.


Please provide the names and dates of schools you have attended.


Experience



About yourself


Please provide a self description.


Please tell us about your current interests and activities.


Please tell us why you would like to become a PARACHUTE volunteer.


Please tell us about your skills and abilities.


Please tell us about your weaknesses.


Training


Monday/Wednesday evenings
Tuesday/Thursday evenings
During the day
All day Saturday
No preference

Times available

Please provide the hours you are available to volunteer.

Miscellaneous


Please pick one. Yes
No



Please pick one. Yes    No



Please pick one. Yes   No



Please pick one. Yes    No



References

Please inform your references that we will be contacting them soon. Please DO NOT include family members as references.


Reference #1

Please provide the name of your reference.

Please provide a phone number for your reference.


Please provide an address for your reference.

  

Please tell us about the relationship between you and your reference.


Reference #2

Please provide the name of your reference.

Please provide a phone number for your reference.


Please provide an address for your reference.

  

Please tell us about the relationship between you and your reference.


Reference #3

Please provide the name of your reference.

Please provide a phone number for your reference.


Please provide an address for your reference.

  

Please tell us about the relationship between you and your reference.


Reference #4

Please provide the name of your reference.

Please provide a phone number for your reference.


Please provide an address for your reference.

  

Please tell us about the relationship between you and your reference.

RELEASE OF INFORMATION

I hereby give my informed consent to the PARACHUTE: Butler County CASA, to complete a thorough investigation of my character and fitness to be a CASA/GAL volunteer. By signing this release, I authorize inquires to be made concerning my suitability as a volunteer to references that I have provided. I further authorize police checks, Bureau of Criminal Investigation checks, children protective services agencies history checks, Prosecutors Office and Bureau of Motor Vehicles. I understand that information requested in this application and other information that may otherwise be obtained will be used only for the purpose of deciding my fitness and suitability to serve as a CASA/GAL volunteer and may be shared with other CASA programs, if appropriate. I further understand that Ohio law may require additional background checks on me in the future to remain a CASA/GAL volunteer. I hereby agree to cooperate with such required checks and/or investigations and to sign all necessary releases or resign as a CASA/GAL volunteer.

The release is good until revoked by me, in writing, at anytime before it has been acted upon. Criteria used in the selection of CASA/GAL volunteers will be such as to ensure that each accepted applicant is able to meet the responsibilities of a CASA/GAL volunteer. No individual will be rejected because of ethnicity, gender, handicap, nationality, race, religion, sexual orientation, age (if at least 21 years of age), or marital status.

I understand that PARACHUTE: Butler County CASA reserves the right to determine which individuals are suitable to become CASA/GAL volunteers. Individuals who have been convicted of a felony, who have been convicted of any criminal act involving drugs or alcohol, or any offense which is listed in the Ohio Revised Code as disqualifier "for those working with children" and/or who have a history with a children protective service agency may not be accepted as a CASA/GAL volunteer. An individual who has been adjudicated to have abused or neglected children including, but not limited to, any sexual offense, abuse, child endangerment, neglect or who has been involved in related acts that would pose a risk to children or to the program's credibility will NOT be accepted as a CASA/GAL volunteer.

Please pick one. You must accept the information above in order to submit. I have read the above information and I agree
I have read the above information and I do not agree