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Adult Guardianship Program
Please complete this application to apply for a volunteer position with the Clark County Adult Guardianship Program.
Please Note: Fields noted with a (*) are required fields.
Your Name
(*)
Please let us know your name.
Date of Birth
(*)
Month
01
02
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/
Day
01
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/
Year
1920
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2005
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2008
2009
2010
2011
2012
2013
Invalid Input
Address
(*)
Invalid Input
City
(*)
Invalid Input
State
(*)
Please Select
IN
KY
Invalid Input
Zipcode
(*)
Invalid Input
Primary Phone
(*)
Invalid Input
Secondary Phone
Invalid Input
Your Email
(*)
Please let us know your email address.
What is the best day/time to contact you?
(*)
Invalid Input
Are you a U.S. Citizen
(*)
Yes
No
Invalid Input
Do you have a valid driver’s license?
(*)
Yes
No
Invalid Input
Do you have transportation available?
(*)
Yes
No
Invalid Input
Education
Did you graduate from high school?
(*)
Yes
No
Invalid Input
Or did you obtain a GED?
Yes
No
Invalid Input
School and year graduated or received GED
(*)
Invalid Input
Legal History
Have you ever been convicted of a misdemeanor or felony?
(*)
Yes
No
Invalid Input
Have you ever been involved as a party in a probate court case?
(*)
Yes
No
Invalid Input
Have you been the subject of a child abuse, domestic violence, or adult protection investigation?
(*)
Yes
No
Invalid Input
Captcha
Invalid Input
Government
Assessor
Auditor
Clerk
Commissioners
Community Corrections
Coroner
Courts
County Council
County Finances
Drainage Board
Emergency Communications
Emergency Management
Extension Office
Fire Departments
Health Department
Highway Department
Planning & Zoning
Prosecutor
Recorder
Sheriff
Solid Waste Mgmt. District
Surveyor
Treasurer
Veterans Service Office
Voting & Elections
Weights and Measures
Residents
AED Program
Animal Welfare
Children & Family
County Budget & Finances
Courts & Law
Election Results
Employment & Jobs
Jury Duty
Land & Property
Public Safety
Ordinances & Resolutions
Recycling & Environment
Voting & Elections
Visitors
Tourism Resources
Clark County Map
Visitor Guides & Maps
About Clark County
Our History
Our Townships
Our County Seat
Vendor Information
Business
County Zoning Ordinance
Local Business News
Calendar
Phone Listing