JV-082 (Rev. 07/31/2018)
Mail Application to:
Administrative Office
Juvenile Court Department
1 Center Plaza, 7th Floor
Boston, MA 02108
APPLICATION
to the
Juvenile Court Department
for Appointment as
Court Investigator
(G.L. c. 119, § 24: Care and Protection Cases)
FOR COURT USE ONLY
Initial Review:
________________________
Approved:
________________________
Entered:
________________________
Name:
Business Address:
Residential Address:
Telephone (Bus): Telephone (Res): FAX:
Email:
All notices and announcements regarding the court investigator fee-generating appointment list are sent by email.
1) I certify that: (check all that apply)
I am a licensed social worker with 3 years experience in child welfare protective cases.
License No.
I have a Masters degree or higher degree in counseling psychology or clinical psychology with at least one year
of experience in child welfare protective cases.
License No.
I have an undergraduate degree and knowledge of child welfare protective cases with demonstrable competence
and at least 3 years experience in conducting investigations.
I am an attorney with at least 3 years experience in child welfare protective cases.
BBO No.
2) I have been appointed as an attorney (Atty), court investigator (CI), and/or a guardian ad litem (GAL) in
the following division(s) of the Juvenile Court: (check all that apply)
Barnstable Berkshire Bristol Essex Franklin/Hamp Hampden
Atty
CI
GAL
Atty
CI
GAL
Atty
CI
GAL
Atty
CI
GAL
Atty
CI
GAL
Atty
CI
GAL
Middlesex Norfolk Plymouth Suffolk Worcester
Atty
CI
GAL
Atty
CI
GAL
Atty
CI
GAL
Atty
CI
GAL
Atty
CI
GAL
3) I will accept appointments from the following (max. three) division(s) of the Juvenile Court Department:
Barnstable
Middlesex
I have a business or residential address in the country, or a county contguous to the county(ies) where I am
applying to accept appointments.
Berkshire
Norfolk
Bristol
Plymouth
Essex
Suffolk
Franklin/Hamp
Worcester
Hampden
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JV-082 (Rev. 07/31/2018)
APPLICATION FOR APPOINTMENT AS COURT INVESTIGATOR
JUVENILE COURT
Name Date
5) Have you ever been investigated by the Department of Children and Families for allegations of child
abuse and/or neglect? If yes, describe the circumstances of the investigation.
No
Yes
6) Use this space to complete any answers to questions asked and/or to include additional information you
feel might favorably affect consideration of your application. Also indicate if you are fluent in another
language. Attach an additional sheet if necessary.
If I am approved to accept appointments, I understand that I am required to participate in eight (8) hours of continuing
education per year. I understand that if I have not mailed the necessary certificate of completion of continuing legal,
clinical, or other education program approved by the Administrative Office of the Juvenile Court by June 30th of each
year, that I will be ineligible to accept appointments. The following documents are attached to my application:
1) Letter of interest addressing my qualifications,
2) Current resume listing my employment,
3) List of relevant educational training and classes in which I participated as an attendee or instructor,
4) Three references including contact information, and
5) Notarized Consent to Criminal Record Check (AOJC form).
I understand that the Administrative Office of the Juvenile Court will not process my application unless I provide all of
the above listed documents.
I certify under the penalties of perjury that all of the above information is true and complete.
Date: _________________________ Signature: ____________________________________________________
FOR OFFICE USE ONLY
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