Online Application

If you are interested in becoming a Court Appointed Special Advocate in the Piedmont region, please fill out this application and click submit. The application help us get to know you better. Once we have received the application, we will contact you with further information. If you would prefer to fill out a paper copy of the application please click here you can mail it back to us or scan it and e-mail it. Please note, this application does not have signature capabilities, at the first training date or during your interview you will receive an application to sign as well.

All fields in this application are required. If you decide after submitting an application that you no longer wish to be a volunteer with Piedmont CASA, please e-mail us and we will remove your contact information from our list.

Employment Information:

Current Employer: *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Length of employment: *

Position/Occupation: *

Applicant Information:

Have you ever been convicted of any violation of law other than minor traffic violations? (A conviction does not necessarily disqualify you from the volunteer program). *

No Yes

If yes, please explain: *

Do you have any health problems which would affect your ability to visit your assigned child at least once a month and attend court hearings? *

No Yes

If yes, please explain. *

References:

Please list two (2) personal references (only one from a family member) AND two (2) professional references (salaried or volunteer work)

Additional Information:

Please explain WHY you would like to be a CASA Volunteer and HOW you hope to benefit from this volunteer experience? *

Explain your philosophy for parenting including the rights and responsibilities of both parent and children: *

Piedmont CASA Application

Employment Information:

Applicant Information:

References:

Additional Information: