For Love of Children - Foster Parent Inquiry Form

FLOC Family Intervention Program
Foster Parent Recruitment and Training

Please fill out this information if you are thinking about becoming a foster parent. A FLOC staff member will contact you to talk to you about the process of becoming a foster parent, answer all of your questions, and assist you if you make a decision to move forward.

Foster Parent Inquiry Sheet

Name:

Spouse/Partner:

Address:

City:

State:

Zip:

Home Phone:

Work Phone:

Email:

CHILDREN AT HOME

Name:

Age:

Name:

Age:

Name:

Age:

OTHERS IN HOUSEHOLD

Name:

Age:

Relationship:

Name:

Age:

Relationship:

Housing?

Number of bedrooms, not including basement:

Are you now or have you ever been a foster parent before? Yes No

If yes, list dates and the agency:

Are you a day care provider? Yes No

How did you learn about For Love of Children?

Please Specify: