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*:
Court Location*:
Circumstances of the Case*:
Please enter the code shown above in the box below: