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CASA Monthly Update Form

*If you have more than one (1) case, please submit one (1) report for each case.

National CASA requires CASA Volunteers to keep monthly activity logs. In addition, the CASA Program can apply for grants and other funding based on the hours spent and miles driven by CASA Volunteers. Please complete your hours and mileage for each month.

CASA Information:

First Name *

Last Name *

Email *

Phone

Case Information:

Case Name *

Number of Children *

Reporting Month/Year (e.g. January 2021) *

Hours volunteered this month. This includes all training, case related activities, time spent documenting, time spent driving, time on the phone with CASA staff or parties to the case, time spent at court- any activity related to volunteering for CASA counts!

Hours *

Miles driven this month for CASA activities.

Miles *

Did you have face to face contact with the child(ren) on your case for this reporting period? *

Yes
No (please provide reason below)

What other types of contact did you make? (select all that apply) *

Attended Court
Phone (e.g., Voice Call, Facetime)
Email
Text Message

Services Provided This Month (select all that apply) *

Advocacy – This should be selected every month. (e.g., attendance at school meetings, court hearings, CCDCFS meetings, collaborating with other professionals)
Documenting (e.g., completing monthly updates and/or court reports)
Investigating (e.g., gathering information on family history, environment, relationships, records review)
Referral (e.g., other services, supports, and community resources)
Monitoring (e.g., compliance of court orders and case plan compliance)

Did the child’s placement change in the reporting month? *

Yes (Please provide new address and date of placement change below)
No

Continuing Education

Summary of In-service Training

List the title and date of each in-service training (e.g., Cultural Diversity, 01-01-21). If you attended an in-service training through CFACC, only submit title and date.

Date:

Training Name:

Type of Activity:

Training Hours:

Date:

Training Name:

Type of Activity:

Training Hours:

Date:

Training Name:

Type of Activity:

Training Hours:

Please submit any questions, comments or concerns.

Signature (type your full name) *

Today's Date (mm/dd/yyyy)

// (mm/dd/yyyy)

Select your assigned CASA Volunteer Coordinator to submit this report to: *

Amber Jackson (ajackson@cfadvocates.org)
Samantha Bensman (sbensman@cfadvocates.org)

Please review your entries before submitting your CASA Monthly Update.

Timeout Warning

CASA Monthly Update Form

CASA Information:

Case Information:

Continuing Education