GAL Volunteer Application Please complete the form below. Once the local GAL office reviews your application, you will be contacted with next steps. Please be prepared to provide three (3) references. First Name Last Name Please list any names, legal or otherwise, that you have been known by: Address (Street, City, State, Zip) Address City State Zip Phone Number County You Wish To Volunteer In - Select -AlamanceAlexanderAlleghanyAnsonAsheAveryBeaufortBertieBladenBrunswickBuncombeBurkeCabarrusCaldwellCamdenCarteretCaswellCatawbaChathamCherokeeChowanClayClevelandColumbusCravenCumberlandCurrituckDareDavidsonDavieDuplinDurhamEBCIEdgecombeForsythFranklinGastonGatesGrahamGranvilleGreeneGuilfordHalifaxHarnettHaywoodHendersonHertfordHokeHydeIredellJacksonJohnstonJonesLeeLenoirLincolnMaconMadisonMartinMcDowellMecklenburgMitchellMontgomeryMooreNashNew HanoverNorthamptonOnslowOrangePamlicoPasquotankPenderPerquimansPersonPittPolkRandolphRichmondRobesonRockinghamRowanRutherfordSampsonScotlandStanlyStokesSurrySwainTransylvaniaTyrrellUnionVanceWakeWarrenWashingtonWataugaWayneWilkesWilsonYadkinYancey Email Date of Birth (mm/dd/yyyy) Gender - Select -FemaleMaleOtherPrefer not to disclose Ethnicity Have you ever been arrested, charged, or convicted of a driving while impaired offense, misdemeanor, or felony other than a minor traffic violation? If so, please explain. (Any applicant found to have been convicted of or have charges pending for a felony or misdemeanor involving a sex offense, child abuse or neglect, or related acts that would pose risks to children or the North Carolina Guardian ad Litem Program's credibility is not eligible to be a GAL volunteer.) Have you ever been arrested, charged, or convicted of a driving while impaired offense, misdemeanor, or felony other than a minor traffic violation? If so, please explain. (Any applicant found to have been convicted of or have charges pending for a felony or misdemeanor involving a sex offense, child abuse or neglect, or related acts that would pose risks to children or the North Carolina Guardian ad Litem Program's credibility is not eligible to be a GAL volunteer.) - Select -NoYes If so, please explain. Have you ever been involved with Child Protective Services or in any civil court proceeding, including but not limited to proceedings involving restraining orders, protective orders, or incompetency proceedings? If so, please explain. Have you ever been involved with Child Protective Services or in any civil court proceeding, including but not limited to proceedings involving restraining orders, protective orders, or incompetency proceedings? If so, please explain. - Select -NoYes If so, please explain. List any reason you can think of that a judge might be reluctant for you to serve as a Guardian ad Litem. Have you lived in North Carolina for the past five (5) years? - Select -NoYes How did you hear about the North Carolina Guardian ad Litem Program? I hereby authorize North Carolina Guardian ad Litem (NCGAL) and any law enforcement or other agencies they authorize to investigate my background to determine my fit as a potential volunteer.* I understand that if for any reason it becomes apparent that my activities are contrary to the policies, goals and/or philosophy of NCGAL, and their desire to provide quality advocacy for abused and neglected children, my services as a NCGAL volunteer will be terminated.* I submit that the statements on this application as true, complete, and correct to the best of my knowledge. I understand that any falsification or omission on this application can disqualify me from consideration or can result in dismissal later.* Print Full Name Date CAPTCHA