Treatment Foster Care Application

    Foster Home Information

    Foster Parent Names (Required):


    Home Telephone Number (Required):

    Email (Required):

    Address (Required):


    Family Information

    Applicant 1

    Date of Birth (Required):

    Place Of Employment:

    Telephone:

    Email:


    Applicant 2

    Date of Birth (Required):

    Place Of Employment:

    Telephone:

    Email:

    Date/ Place of Marriage or cohabitation:


    Child(ren)

    Other person(s) residing in the Home

    Are you able to ensure a smoke free environment?YesNo

    Have you ever been charged with an offense under the criminal code?YesNo

    Describe your home:

    Have you had any training or experience in caring for a child other than your own?YesNo

    Have you fostered in the past or are you currently applying to foster for other agencies at the present time?YesNo

    The Child/Children you wish to foster

    How old are they:
    Are they male or female?:

    Comments:


    Fostering Options:

    Would you and your family be willing to consider fostering a child on a short term or emergency basis?YesNo

    Would you be willing to consider short-term relief placements? Such occasional weekends for a child in another foster family?YesNo

    Would you be willing to consider a child that required intensive supports? i.e. A Clinical support Worker in the home 24 hours per day?YesNo

    Are you willing to have one foster parent not work outside of the home?YesNo

    Would you consider fostering sibling groups?YesNo

    Type in what you see before submitting. Thank you

     

     

    Note

    During the home study process we will ask you to provide us with supporting documentations that assists in the approval process of the home study. These include but are not limited to written references, criminal record check, child welfare check, and a medical check of all family members over 18 years.

    Participating in the Home study process does not guarantee acceptance as a Foster Family.

    Documentation required prior to approval