"Application for Court Aide Service" - Connecticut

Application for Court Aide Service is a legal document that was released by the Connecticut Judicial Branch - a government authority operating within Connecticut.

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Download "Application for Court Aide Service" - Connecticut

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STATE OF CONNECTICUT
JUDICIAL BRANCH
APPLICATION FOR COURT AIDE SERVICE
PERSONAL INFORMATION
NAME
HOME ADDRESS (Street)
(City)
(State)
(Zip Code)
TELEPHONE NO.
(
)
Parents’ Name
Parents’ Telephone Number
DATE OF BIRTH
PLACE OF BIRTH (List City & State)
NAME OF EMERGENCY CONTACT
PHONE NUMBER OF EMERGENCY
CONTACT
(
)
PLEASE LIST ANY LANGUAGES YOU SPEAK FLUENTLY:
EMAIL ADRESS:
HAVE YOU EVER BEEN CONVICTED OF A CRIME?
NO
DO YOU HAVE ANY CASES PENDING IN CT OR ANY OTHER
NO
STATE?
IF YES, PLEASE EXPLAIN:
IF YES, PLEASE EXPLAIN:
SCHOOL DATA
NAME OF HIGH SCHOOL
HIGH SCHOOL ADDRESS
PROGRAM
CAREER COUNSELOR
PHONE NUMBER:
(
)
EXT:
CURRENT
SENIOR
GRADUATION DATE:
LEVEL
Yes
No
REQUIRED NUMBER OF HOURS
Have you ever held a paid position?
If yes, how long did you work in that position?
Yes
No
Do you plan on attending college?
Have you been accepted at a college or university?
What will be your major?
Yes
No
Yes
No
PLEASE EXPLAIN BELOW WHY YOU WOULD LIKE TO PARTICIPATE IN THE JUDICIAL BRANCH COURT SIDE PROGRAM. (PLEASE ATTACH AN
ADDITIONAL SHEET, IF NECESSARY.)
BACKGROUND INFORMATION
I authorize the Judicial Branch to conduct a verification of education and criminal history records pertaining to me. I hereby authorize persons,
schools and other organizations to release to the Judicial Branch information that may be requested. I agree to discharge the Judicial Branch and its
employees from any claims, damages and liabilities arising from the retrieval, reporting or dissemination of information authorized by this release.
APPLICANT'S SIGNATURE
DATE SIGNED
Please return the form to: Judicial Branch-Volunteer/Intern Program
99 East River Drive, Room 701 Two Riverview Square, East Hartford, CT 06108
Phone: (860) 282-6581 Fax: (860) 282- 6585
STATE OF CONNECTICUT
JUDICIAL BRANCH
APPLICATION FOR COURT AIDE SERVICE
PERSONAL INFORMATION
NAME
HOME ADDRESS (Street)
(City)
(State)
(Zip Code)
TELEPHONE NO.
(
)
Parents’ Name
Parents’ Telephone Number
DATE OF BIRTH
PLACE OF BIRTH (List City & State)
NAME OF EMERGENCY CONTACT
PHONE NUMBER OF EMERGENCY
CONTACT
(
)
PLEASE LIST ANY LANGUAGES YOU SPEAK FLUENTLY:
EMAIL ADRESS:
HAVE YOU EVER BEEN CONVICTED OF A CRIME?
NO
DO YOU HAVE ANY CASES PENDING IN CT OR ANY OTHER
NO
STATE?
IF YES, PLEASE EXPLAIN:
IF YES, PLEASE EXPLAIN:
SCHOOL DATA
NAME OF HIGH SCHOOL
HIGH SCHOOL ADDRESS
PROGRAM
CAREER COUNSELOR
PHONE NUMBER:
(
)
EXT:
CURRENT
SENIOR
GRADUATION DATE:
LEVEL
Yes
No
REQUIRED NUMBER OF HOURS
Have you ever held a paid position?
If yes, how long did you work in that position?
Yes
No
Do you plan on attending college?
Have you been accepted at a college or university?
What will be your major?
Yes
No
Yes
No
PLEASE EXPLAIN BELOW WHY YOU WOULD LIKE TO PARTICIPATE IN THE JUDICIAL BRANCH COURT SIDE PROGRAM. (PLEASE ATTACH AN
ADDITIONAL SHEET, IF NECESSARY.)
BACKGROUND INFORMATION
I authorize the Judicial Branch to conduct a verification of education and criminal history records pertaining to me. I hereby authorize persons,
schools and other organizations to release to the Judicial Branch information that may be requested. I agree to discharge the Judicial Branch and its
employees from any claims, damages and liabilities arising from the retrieval, reporting or dissemination of information authorized by this release.
APPLICANT'S SIGNATURE
DATE SIGNED
Please return the form to: Judicial Branch-Volunteer/Intern Program
99 East River Drive, Room 701 Two Riverview Square, East Hartford, CT 06108
Phone: (860) 282-6581 Fax: (860) 282- 6585