Home » Volunteer » Volunteer Application Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Your Phone*Your Email* Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920How long have you lived in Massachusetts?*Please check all that apply:* Asian-American African-American Caucasian Hispanic-Latino Native-American Other Female Male Level of education*Employment Status*Part TimeFull TimeRetiredUnemployedStudentEmployerEmployer AddressYour Title*How did you initially hear about The CASA Project?*Have you or your family ever been involved with the Department of Children and Families (currently DCF formerly DSS) or the Worcester Juvenile Court in Massachusetts, or the agency of another state as an employee, volunteer or client? If so, please explain.*Have you ever been convicted of a crime? If so please explain the nature of the crime. (This would not automatically preclude you from becoming a volunteer.)*Signature*I CERTIFY THAT ALL THE ABOVE IS TRUE AND CORRECT. I UNDERSTAND THAT IF AN INVESTIGATION DISCLOSES UNTRUTHFUL OR MISLEADING ANSWERS, MY VOLUNTEER APPLICATION MAY BE REJECTED OR MY VOLUNTEER POSITION TERMINATED.