Form AOC-CFCRB-8 "Kentucky Citizen Foster Care Review Board Volunteer Application" - Kentucky

What Is Form AOC-CFCRB-8?

This is a legal form that was released by the Kentucky Court of Justice - a government authority operating within Kentucky. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2015;
  • The latest edition provided by the Kentucky Court of Justice;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form AOC-CFCRB-8 by clicking the link below or browse more documents and templates provided by the Kentucky Court of Justice.

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Download Form AOC-CFCRB-8 "Kentucky Citizen Foster Care Review Board Volunteer Application" - Kentucky

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AOC-CFCRB-8
Date Reviewed: _________________
Rev. 7-15
l e x
Date CAN Check:________________
Page 1 of 2
e t
j u s t i t i a
Date Record Checked:____________
Commonwealth of Kentucky
KENTUCKY CITIZEN FOSTER CARE
Date Trained:___________________
Court of Justice
www.courts.ky.gov
REVIEW BOARD
Date Appointed:_________________
VOLUNTEER APPLICATION
NAME: ________________________________________________________________________
ADDRESS: ______________________________________________
E-MAIL: _____________________________
CITY: __________________________________________ STATE: ___________________
ZIP:______________
WORK : ______________________ HOME: __________________________ CELL: ________________________
DATE OF BIRTH: __________________________
SOCIAL SECURITY#: _______________________________
COUNTY IN WHICH YOU WISH TO SERVE: __________________________________________
CURRENT EMPLOYER: ___________________________ FROM: __________________ TO: _________________
OCCUPATION: _________________________________________________________________
VOLUNTEER EXPERIENCE: ______________________________________________________
The following questions are used to select a local board that is representative of the community. Answering them is optional.
RACE: _____CAUCASIAN
____MALE
FAMILY INCOME: ____LESS THAN $25,000
_____ASIAN
____FEMALE
____$25,001-$40,000
_____AFRICAN AMERICAN
____$40,001-$65,000
_____OTHER
MARITAL STATUS:
____OVER $65,000
HISPANIC ___YES___NO
____ SINGLE
____ MARRIED
HIGHEST LEVEL OF EDUCATION COMPLETED:
_____HIGH SCHOOL
_____BACHELORS DEGREE
_____MASTERS DEGREE
_____DOCTORATE
ARE YOU OR HAVE YOU BEEN A FOSTER PARENT? ____NO ____PRESENTLY AM ____FORMERLY WAS
ARE YOU AN ADOPTIVE PARENT? _____YES ______NO
HAVE YOU EVER BEEN CONVICTED FOR VIOLATION OF ANY LAW (OTHER THAN TRAFFIC OFFENSES) OR
ARE ANY LEGAL CHARGES PENDING AGAINST YOU?(Criminal record checks will be conducted) ___YES ___NO
IF YES, PLEASE LIST THE DATE, OFFENSE, DISPOSITION AND ANY CIRCUMSTANCES? ____________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
HAVE YOU EVER HAD A SUBSTANTIATION OF CHILD ABUSE OR NEGLECT?(Central Registry Checks will be
conducted) ____YES _____NO
IF YES PLESE LIST THE DATE AND CIRCUMSTANCES? ________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
ARE YOU AN EMPLOYEE OF THE CABINET FOR HEALTH AND FAMILY SERVICES (CHFS)? ___YES ___NO
AOC-CFCRB-8
Date Reviewed: _________________
Rev. 7-15
l e x
Date CAN Check:________________
Page 1 of 2
e t
j u s t i t i a
Date Record Checked:____________
Commonwealth of Kentucky
KENTUCKY CITIZEN FOSTER CARE
Date Trained:___________________
Court of Justice
www.courts.ky.gov
REVIEW BOARD
Date Appointed:_________________
VOLUNTEER APPLICATION
NAME: ________________________________________________________________________
ADDRESS: ______________________________________________
E-MAIL: _____________________________
CITY: __________________________________________ STATE: ___________________
ZIP:______________
WORK : ______________________ HOME: __________________________ CELL: ________________________
DATE OF BIRTH: __________________________
SOCIAL SECURITY#: _______________________________
COUNTY IN WHICH YOU WISH TO SERVE: __________________________________________
CURRENT EMPLOYER: ___________________________ FROM: __________________ TO: _________________
OCCUPATION: _________________________________________________________________
VOLUNTEER EXPERIENCE: ______________________________________________________
The following questions are used to select a local board that is representative of the community. Answering them is optional.
RACE: _____CAUCASIAN
____MALE
FAMILY INCOME: ____LESS THAN $25,000
_____ASIAN
____FEMALE
____$25,001-$40,000
_____AFRICAN AMERICAN
____$40,001-$65,000
_____OTHER
MARITAL STATUS:
____OVER $65,000
HISPANIC ___YES___NO
____ SINGLE
____ MARRIED
HIGHEST LEVEL OF EDUCATION COMPLETED:
_____HIGH SCHOOL
_____BACHELORS DEGREE
_____MASTERS DEGREE
_____DOCTORATE
ARE YOU OR HAVE YOU BEEN A FOSTER PARENT? ____NO ____PRESENTLY AM ____FORMERLY WAS
ARE YOU AN ADOPTIVE PARENT? _____YES ______NO
HAVE YOU EVER BEEN CONVICTED FOR VIOLATION OF ANY LAW (OTHER THAN TRAFFIC OFFENSES) OR
ARE ANY LEGAL CHARGES PENDING AGAINST YOU?(Criminal record checks will be conducted) ___YES ___NO
IF YES, PLEASE LIST THE DATE, OFFENSE, DISPOSITION AND ANY CIRCUMSTANCES? ____________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
HAVE YOU EVER HAD A SUBSTANTIATION OF CHILD ABUSE OR NEGLECT?(Central Registry Checks will be
conducted) ____YES _____NO
IF YES PLESE LIST THE DATE AND CIRCUMSTANCES? ________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
ARE YOU AN EMPLOYEE OF THE CABINET FOR HEALTH AND FAMILY SERVICES (CHFS)? ___YES ___NO
AOC-CFCRB-8
Page 2 of 2
EMPLOYEES OF THE CABINET ARE PROHIBITED FROM SERVING ON THE CITIZEN FOSTER CARE REVIEW
BOARDS. LIKEWISE, BOARD MEMBERS WHO HAVE A CONFLICT OF INTEREST CANNOT PARTICIPATE IN SUCH
REVIEWS. PLEASE DESCRIBE THE NATURE OF ANY OF YOUR CURRENT OR PREVIOUS CONTACTS WITH CHFS
AND ANY POTENTIAL CONFLICT(S) OF INTEREST?________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
MARK THE DAYS AND TIMES THAT YOU ARE AVAILABLE TO ATTEND REVIEW BOARD MEETINGS.
___ MONDAY
___ MORNING
___ TUESDAY
___ AFTERNOON
___ WEDNESDAY
___ EVENING (AFTER 4:30 P.M.)
___ THURSDAY
___ FRIDAY
WHAT ARE YOUR REASONS FOR WANTING TO SERVE ON THE REVIEW BOARD? _________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
HOW DID YOU HEAR ABOUT THE CITIZEN FOSTER CARE REVIEW BOARD PROGRAM? ____________________
_______________________________________________________________________________________________
ALL VOLUNTEERS MUST COMPLETE AN INITIAL SIX HOUR TRAINING SESSION BEFORE REVIEWING CASES.
PLEASE INDICATE WHICH DATES AND TIMES ARE MOST CONVENIENT FOR YOU.
WEEKDAYS
________________
WEEKENDS
_______________
THE CHFS FILE INFORMATION PERTAINING TO CHILDREN IN FOSTER CARE IS CONFIDENTIAL. AS A VOLUNTEER,
YOU ARE REQUIRED TO TAKE AN OATH TO KEEP CONFIDENTIAL THE INFORMATION REVIEWED BY THE BOARD
AND ITS ACTIONS AND RECOMMENDATIONS IN INDIVIDUAL CASES. VIOLATION OF THIS OATH WILL SUBJECT
YOU TO PROSECUTION FOR THE MISDEMEANOR OFFENSE OF OFFICIAL MISCONDUCT OR FELONY OFFENSE
OF MISUSE OF CONFIDENTIAL INFORMATION. AS A VOLUNTEER YOU ARE REQUIRED TO ATTEND THE SIX HOUR
TRAINING SESSION. YOUR SIGNATURE BELOW INDICATES THAT YOU AGREE TO THESE REQUIREMENTS.
________________________________________________
______________________________________
SIGNATURE
DATE
Print
Please complete the application and Central Registry Check. Return to:
Citizen Foster Care Review Board Program
Reset Form
Administrative Office of the Courts
1001 Vandalay Drive
Frankfort, KY 40601
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