GAL Application - Become A GAL in SC
GAL Application - Become A GAL in SC
Name_____________________________________________________________________________________
Last First Maiden/Middle Preferred Name
Home Address______________________________________________________________________________
Street/Mailing Address City/State/Zip County
Email: _________________________________________
Optional: In order to determine if our volunteer pool reflects the diversity of the community, please indicate your ethnic group(s):
__________________________________________________________________________________________
Although no special experience is required, do you have training, knowledge, or skills in any of the following areas?
Advertising or Public Relations Criminology or Law Enforcement Mental Health
Child Care Drug or Alcohol Abuse Counseling Parenting
Child Welfare Social Work Management Psychology
Clerical/Computer Marketing/Sales Public Speaking
Counseling Medical Training/Instructing
Other
Are you willing to volunteer in other areas of our program?___________________________ If so, what areas?
_________________________________________________________________________________________
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Have you or your immediate family ever been involved in Family Court Proceedings? Yes No
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Have you ever been employed with DSS? Yes No If yes, list when and what type employment.
__________________________________________________________________________________________
Have you ever been a foster parent? Yes No If yes, with whom.______________________________
Have you ever been convicted of a crime other than a minor traffic violation? Yes No
If yes, please describe (including charge, disposition of charges, and date of conviction, county, state) on a separate page.
Can you think of any reason why a judge might be reluctant for you to serve as a volunteer Guardian ad Litem?
__________________________________________________________________________________________
__________________________________________________________________________________________
How long have you lived in this county/community?______________ If less than two years, please give
previous address: ___________________________________________________________________________
Please list as references three people who know you well, at least one for whom you have worked in either a
paid or unpaid capacity. Please do not list relatives.
Are you willing to commit at least two years of volunteer service? Yes No
I declare that all of the preceding information is true and correct to the best of my knowledge as of the date of
this application. I understand that any false or misleading information given by me can disqualify me from
consideration, or result in dismissal at a later time. I hereby authorize the Office of the Governor to run a
criminal history check with SLED/NCIC and give said results to the Coordinator of the
_____________________ County Guardian ad Litem Program. I further authorize the Department of Social
Services to determine if I have ever been reported for child abuse/neglect or have a founded case against me. I
understand that the information so released may prove unfavorable to me. I further authorize inquiries to be
made concerning my suitability as a Guardian ad Litem. If I am accepted as a volunteer, I understand that I will
have an ongoing obligation to notify the ____________ County Guardian ad Litem Program if I am at any time
under investigation for any of the crimes listed in S.C. Code Ann. §20-7-123 (Supp. 2006) or if I am at any time
under investigation by the Department of Social Services for any type of abuse or neglect action.
_______________________________________________________ ______________________________
(Applicant’s Signature) (Date)
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If you have lived outside the state of South Carolina in the past five years, please provide your
complete address(es)____________________________________________________________
_____________________________________________________________________________
Please list the date, type and outcome of any criminal convictions:________________________
_____________________________________________________________________________
_____________________________________________________________________________
I hereby authorize the Office of the Governor to conduct a search of all convictions or pending charges on me and to
release the printed results of the inquiry to the Division of Guardian ad Litem. I understand that the information released
may prove unfavorable to me, and I release all persons whomever and the Office of the Governor from any liability
resulting from the release of this information.
_____________________________________________ __________________________________
Signature of Applicant Date
In the space provided or on a separate sheet of paper, please write a brief autobiography. We would like to
know more about you before you begin the training. This summary will help us make your training and
Guardian ad Litem experience as meaningful as possible. Please include your autobiography with your
application and mail to the GAL office. Thank you.