CASA Reference Form    

CASA Reference
 CASA  AZ Volunteer Professional Reference Form
Volunteer Applicant's Name: Taylor, Linda
Person Giving Reference: Podsiadlo, Sharon
Email: [email protected]
Address: 1313 W. Glendale Ave. City: Phoenix
State: AZ Zip Code: 85021

Instructions: The applicant listed above has applied to become a Court Appointed Special Advocate (CASA) for an abused or neglected child involved in the Juvenile Court system. This is a very important position involving direct service to vulnerable children. Because of the need to protect these children from further victimization, we employ a multi-step screening process to ensure the suitability of each applicant for the program.

Please complete each of the following questions as thoroughly and accurately as possible. Thank you for your assistance.
How long have you known the applicant?
What is the nature of your relationship?
When was the last time you had contact with him/her?
Ability to get along with others:
Ability to meet deadlines:
Ability to remain objective in emotionally-charged situations:
Ability to work with children:
Compliance with procedures:
Honesty/Trustworthiness:
Judgement:
Maturity level:
Professionalism:
Reliability/Dependability:
Stablilty:
Verbal communication skills:
Written communication skills:

How would you rate the applicant's ability to handle the following situations:
Having to make a recommendation in a meeting where he/she knew others present were going to disagree with him/her?

Please describe:
Trying to get information about a situation from someone who doesn't want to talk to her/him?

Please describe:
Have you ever seen the applicant interact with children? If yes, please rate:
Ability to work with children (i.e. appropriateness of relationships with children, ability to set limits, etc.) Please describe their interaction:


How does the applicant relate to/work with persons of various ethnic/cultural/racial/social economic groups?


Does the applicant use a computer to communicate with others?


This volunteer opportunity requires a minimum commitment of one year, involving approximately 15-20 hours per month of direct and telephone contact with the child and others involved in the case. Do you believe the applicant has the time available to commit to the CASA Program?


Recognizing that the applicant will be working directly with vulnerable children with histories of abuse and/or neglect, do you recommend this applicant?

Please provide any additional information that may be helpful to us in determining the applicant's suitability for the CASA Program.