Fill - Free fillable ASHEBO RO /RAN DOLPHTEENCOURTPROGRAM (Randolph County) PDF form

ASHEBO RO /RAN DOLPHTEENCOURTPROGRAM

TerraLataille,Coordinator

1520NorthFayettevilleStreet

Asheboro,NC27203

Phone:(336)683‐8229Fax:(336)683‐8217

tmlataille@co.randolph.nc.us



STUDENTVOLUNTEERAPPLICATION



DateofApplication:______________



RoleInterest(Circleallthatapply):Attorney Jury ClerkofCourt Bailiff



ConfidentialInformation‐Pleaseprintorcompleteoncomputer.



Name:

_____________________________________________________



Sex:_________Age:_________DateofBirth:______________



StreetAddress:

_____________________________________________________



_____________________________________________________



HomePhone:________________________ CellPhone:________________________



E‐mailAddress:_____________________________________________________



Parent/GuardianName:__________________________________Relationship:________________________



NameofSchool:__________________________________ Grade:______________



WhyareyouinterestedinTeenCourt?

__________________________________________________________

_____________________________________________________________________________________________



WhatqualitiesdoyouhavethatwouldmakeyouagoodTeenCourtvolunteer?

_____________________________________________________________________________________________



Listtheactivitiesyouareinvolvedinbothinsideandoutsideofschool(example):band,sports,scouts,

etc.).Aretherecertaindaysortimesoftheyearthatyouwouldnotbeavailable?

_____________________________________________________________________________________________



Pleaselisttworeferences(non‐relative,onemustbeanadultfromtheschoolyouattend):



Name&Position:

_____________________________________________________________________________



Phone:

_______________________________



Name&Position:

_____________________________________________________________________________



Phone:

_______________________________



StudentVolunteer:

IunderstandthatImaybecalled uponatanytimetoserveinTeenCourt.Iwilltakemyresponsibility

seriouslyandwillmaintainconfidentialityregardingallTeenCourtproceedings.IunderstandthatifI

neglectmyresponsibilitiesorbreachmyoathofconfidentiality,Iwillbe

removedfromservinginthe

TeenCourtProgram.



StudentVolunteerSigna ture:

________________________________________________________



Parent/Guardian:

IhavereadtheinformationaboutTeenCourtandamallowingmydaughter/sontoparticipateasaTeen

Courtvolunteer.Iunderstandthatwe,asparent(s)/guardian(s)areinvitedtoattendtheTeenCourt

TrainingSessionsandHearingswithourdaughter/son.Ifurtherunderstandthatallcaseinformationis

tobe

keptCONFIDENTIAL.



Parent/GuardianSignature:

________________________________________________________



Whenapplicationiscompleted,returnsignedoriginalbymailto:

TerraLataille

TeenCourtCoordinator

1520NorthFayettevilleStreet

Asheboro,NC27203



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ASHEBO RO RAN DOLPHTEENCOURTPROGRAM (Randolph County)

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