Page 8 of 8 Guardian ad Litem Application Form | http://bit.ly/NV_GAL rev 11/27/19
The information requested in this application and other parts of the background check and selection process
will be used only for the purpose of determining suitability as a GAL, and will be kept in condence.
BY SUBMITTING THIS APPLICATION, I AGREE TO AND/OR AUTHORIZE THE FOLLOWING:
I hereby declare the information provided by me in this application is true, correct and complete to
the best of my knowledge. I understand that if accepted, any misrepresentation or omission of fact
may cause my disqualication and/or immediate termination. I understand that if I refuse or fail to
sign this application, my application will be rejected.
I understand that by submitting this application, I am authorizing that inquiries be made concerning my
suitability as a GAL. The background investigation will include a reference check, as well as a formal
security check. I acknowledge that if I am found to have been convicted of a felony, or to have current
charges pending for a felony or misdemeanor involving a sex offense, child abuse, or child neglect, I
will be ineligible to serve in the role of a GAL.
I authorize the local District Court Guardian ad Litem staff to interview me in depth regarding my
personal background and experiences that may be relevant to my role as a Guardian ad Litem. Children
in the GAL program have experienced or witnessed a variety of personal challenges including emotional,
physical or mental abuse or neglect, sexual abuse, substance abuse and/or mental illness. Because
appropriate assignment of a child depends on the GAL’s own experiences of these issues, I understand
that my GAL interview will include questions about these sensitive topics. If I become uncomfortable
with these questions I will be free to terminate the interview, but I understand that my application will
then be considered withdrawn.
I understand that GALs are selected based on their individual ability to meet the responsibilities of
the GAL program, as determined at the discretion of the local District Court Program Coordinator. I
also understand that because of the condential nature of the screening process, this agency is not
obligated to disclose to me reasons or sources for any decision concerning my acceptance or non-
acceptance into the GAL program. I understand that all materials I submit, and forms submitted by
references, become property of the GAL program and will not be returned. Furthermore, I hereby
waive any claim that the selection practices and policies described above are an invasion of privacy.
I understand that the agency must take the best interest of the children into consideration rst when
matching them with a GAL. Thus, I understand that in the event that I should complete the entire GAL
training, (1) the GAL program is not obligated to certify me (present me to the Court to be sworn as
a Guardian ad Litem), (2) the GAL program is not obligated to assign, or to actively seek to assign to
me a child, and (3) I am not obligated, if called upon, to perform volunteer services herein applied
for. However, no individual will be rejected because of disability, ethnicity, color, sex, gender identity,
marital status, religion, national origin, race, age, or sexual orientation.
I understand that I must complete approximately 40 hours of training that includes the observation
of court proceedings before being considered for certication as a GAL. I further understand that I
must participate in an additional 12 hours of continuing education each year. If selected for program
certication and assigned to a child’s case, I understand that my duties will include court appearances,
and may include written reports, visits to homes of family members involved in the case or children’s
treatment programs.
Finally, I recognize that any changes made to the understandings above must be made in writing and
signed by the local District Court Program Coordi
nator.
Printed Name: _____________________________________________________________________
Signature: ________________________________________________________________________
