Request a CASA
© National CASA Association

The court typically makes the request that a CASA volunteer be assigned to a child. If you know of a situation where you feel that a child may benefit from being assigned a CASA volunteer then you may send in a request through the form below. Please note that all referred cases will not necessarily receive a CASA volunteer. You will not receive any correspondence as to the status of a referred case. Fields marked with an * are required fields.
 Child Information
Child's First Name*:
 
Child's Last name*:
 
Child's Date of Birth:
JD Number:
Location of child*:
 
 
Referral Contact
Referral First Name*:
 
Referral Last Name*:
 
Agency*:
 
Phone*:
 
Email*:
 
Court Location*:
 
Circumstances of the Case*:
 
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