Current Active Volunteers:
Please fill out and submit this form every month
in order to track your CASA case activities.
Volunteer Activities Form
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Group
number
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Submitted
by
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Date
Submitted
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Form # of
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Volunteer name______________________________________________________________________________
Report for month of ____________________________________Page___________ of____________
Volunteer activities
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Child’s Name
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Date of Activity
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Type of activity (see codes below)
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Type of contact
(see codes below)
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Out of Court?
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Time spent
(to 1/4 hour)
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Miles driven
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Activity codes (26)
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1 Attended foster care review
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6 Child contacted out of court
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11 Wrote reports
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2 Attended hearing
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7 Collaterals contacted
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12 Other
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3 Attended social service review
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8 Foster parents contacted
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4 Biological parents contacted
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9 Relatives contacted
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5 CASA supervisor contacted
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10 Traveled
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Contact codes (28)
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1 Face-to-face
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2 E-mail
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3 Phone
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4 Written
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5 Other
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Notes______________________________________________________________________________
__________________________________________________________________________________________________