All prospective volunteers must submit to a full background check, including a Child Protective Services (CPS) Background Clearance. Please follow the directions below to complete the form which will allow us to conduct this clearance.
Below you will find the link with instructions to complete the form ONLINE, print it out and have it notarized. After your form is notarized, please email it to staff@pgcasa.org, drop it off at the CASA office or mail it via (US mail) to CASA at 6811 Kenilworth Avenue, Suite 402 Riverdale, MD 20737.
Please submit your form to CASA as soon as possible. CPS’ turn-around can take 6 or more weeks which could potentially delay you starting your first case.
CPS BACKGROUND CLEARANCE REQUEST DIRECTIONS
Please click on the following link to proceed with filling out the clearance form.
- Under Part 1A you will check the first box “To determine if I have been found responsible for an “indicated” or “unsubstantiated” disposition for a child abuse or neglect investigation”
- Under 1B you will check the box that says “CASA” and then proceed with filling out the rest of the form as indicated.
- For Agency- fill in CASA’s information. Agency: CASA/Prince George’s County. Agency Representative: London Gilchrist. Agency Address: 6811 Kenilworth Avenue, Suite 402 Riverdale, MD 20737. Phone: 301-209-0491. Email: staff@pgcasa.org
- All forms should be completed electronically and cannot be hand written. Complete the form on-line and then print it. (You may want to save the form to your computer.) INCOMPLETE OR ILLEGIBLE FORMS WILL BE RETURNED AND WILL CAUSE A DELAY IN THE REQUEST BEING PROCESSED. If you do not have access to a computer, the internet, or a printer you may complete the form at the CASA office.
- Do not sign the form until you go to the notary public. Provide proof of identity to the Notary Public when you sign Part IV. The Notary’s original seal is required on all forms.
You may notarize your form at UPS, your bank or a local notary. You may incur a small fee to do so.
NOTE: If you do not live in Maryland, contact CASA for the link to the appropriate form.
NOTE:
- If you have been issued a Social Security Number, you MUST provide it so a thorough search can be conducted.
- Information on family members is requested in the event the applicant has the same name as another person known to the department, to help determine the correct person.
- Your signature is only valid for 1 year.
- The applicant’s signature should be signed in blue ink.
- If you are a resident of Washington DC, please use this form.
- If you are a resident of Virginia, please use this form.
