Friends of the Portsmouth Juvenile Court, Inc. requests the following information because of our commitment to the children and young adults who benefit from our services. All organizations that provide services to youth must take reasonable precautions when recruiting and supervising volunteers. The information you provide is confidential and for internal use only.

FOPJC is an Equal Opportunity Employer and does not discriminate against any qualified applicant on the basis of race, religion, color, gender, national origin, disability, age, sexual orientation or any other basis made illegal by the laws of the United States or the Commonwealth of Virginia.

If you choose not to sign a release of information form or submit the required information or fingerprints for any of the mandatory background checks, your application will be rejected.

If you are applying to CASA, please see *About Me section at end of this application.

Previous Employer(s)

Previous Employer(s)

Previous Employer(s)

Education

If you are currently enrolled in an educational or training institution, please provide the following:

References

Please list three (3) individuals who know you well, preferably someone for whom you have worked in a paid or unpaid capacity. Do not list relatives. If you are currently employed, please include your supervisor.

References

Please list three (3) individuals who know you well, preferably someone for whom you have worked in a paid or unpaid capacity. Do not list relatives. If you are currently employed, please include your supervisor.

Emergency Contact

In case of an emergency, who should we contact?

The following information is requested for statistical purposes only:

As a volunteer/intern with the Friends of the Portsmouth Juvenile Court, Inc. I understand I will be volunteering, either directly or indirectly, with children or juveniles who have been before the Portsmouth Juvenile and Domestic Relations Court.

I understand that compliance with all of the requirements below is mandatory for the safety of all involved.

I affirm that the information given in this application is true and accurate to the best of my knowledge.