WE DESPERATELY NEED FOSTER HOMES WITH FLEXIBLE SCHEDULES FOR KIDS AGES 10-18.

Foster Care Application

Doug, Dane County

Fostering has been fulfilling, especially when the kids contact us after leaving foster care.

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Foster Care Application

Please complete the following application so that we can get to know you as a prospective foster parent. Your answers will allow us to get to know you as a prospective foster parent. Do not leave any blanks. If something does not apply, please indicate so with N/A. If you are a single applicant, please enter N/A in all sections pertaining to Application #2.

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • If less than 5 years for either applicant, please list previous address(es) for this period.
  • Children Living in your Household:
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Other Adults/Adult Children Living in your Home:
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Bedroom Size (approximate)Location (Floor)Occupied By: 
    Please list all bedrooms in your home below. Be sure to indicate where everyone in your household sleeps and where prospective foster children will sleep. (A legal bedroom must have a door and a window.)
  • Species & NameAgeDescribe Temperament with Children 
  • Current Employment: List all full-time and part-time work, including any self-employment and childcare.
  • Applicant #1

  • Length of Employment:
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Hours Worked:
  • Previous Employment: Please go back 5 years
  • Employer Name & AddressJob TitleEmployment Dates 
  • Applicant #2

  • Length of Employment:
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Hours Worked:
  • Previous Employment: _Please go back 5 years
  • Employer Name & AddressJob TitleEmployment Dates 
  • Schools for your Home Address:
  • Elementary School:
  • Middle School:
  • Junior High School:
  • Senior High School:
  • Parochial or School Choice:
  • As a child placing agency, we assume responsibility for placing children in secure, healthy family situations. The information requested below will help us determine the suitability of placing children in your home. Answering “yes” to any question below will not necessarily disqualify you from being considered. Providing false information on this form is grounds for certification/licensure denial or revocation.
  • Have you or anyone in your family experienced any of the following:
  • PLEASE USE ADDITIONAL PAPER IF YOU NEED MORE SPACE (write N/A if it does not apply):
  • I, the applicant named below, agree to provide Community Care Resources with sufficient information to verify that licensing requirements are met. I further authorize Community Care Resources to investigate as is necessary for verification including access to my home or records regarding the children placed in my home. I understand that this may include Community Care Resources reviewing social media accounts and other available online internet sources. By typing my signature below, I understand that it constitutes a legal signature confirming that I acknowledge and agree to the above terms.
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • ADDITIONAL NOTES

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