Foster Parent Inquiry Form
Applicant name:
*
First Name
Last Name
Address:
*
City:
*
Zip code:
*
Home Phone:
*
-
Area Code
Phone Number
Work Phone
-
Area Code
Phone Number
Cell Phone:
-
Area Code
Phone Number
E-mail
*
Are you at least 25 years old?
*
Yes
No
Are you able to communicate in English?
*
Yes
No
Marital Status:
*
Single
Married
Divorced
Partnered
What is your current living situation?
*
Own
Rent
How did you hear about our agency/program?
*
Have you ever applied or been licensed by Family Service of RI before?
*
Yes
No
What is your current source of income?
*
Employed full time
Employed Part Time
SSI or SSDI
Unemployment benefits
Other (specify below)
Other source of income
*
Can you provide the child the appropriate bedroom space?(Min 50 sq ft.)
*
Yes
No
Do you have a valid driver's license?
*
Yes
No
Do you have reliable transportation?
*
Yes
No
Have you or any household member ever been investigated by DCYF or any state welfare department?
*
Yes
No
Will all household members be able to pass a state and national criminal background check?
*
Yes
No
Please list all household members and their ages:
*
Submit
Should be Empty: