Gwinnett County CASA Inquiry Form

Fields marked are required.

Name

Email Address

Phone Number

Street Address

Apt / Suite / Other

City

State

Zipcode

Do you meet the age requirement of 21yrs. and over?

Do you have any criminal history that may prevent you from becoming a volunteer?

Have you ever been involved with child protective services (in or out-of-state)

May we contact you to provide additional information?