FOSTER PARENT APPLICATION

Requirements for Foster/Adoptive Applicants:
  • At least 25 years old
  • Married for at least two years or single. Both spouses complete the process to become verified.
  • If divorced, legally divorced for at least 6 months
  • Proof of homeowner’s/renter’s insurance with liability
  • Proof of High School Diploma/GED

FOSTER PARENT APPLICANT INFORMATION

History of Residence for Past Ten (10) Years:
Children Still In Home:
EMPLOYMENT AND INCOME:

** Both adults need to attach a copy of their paystub or W-2 to the completed application.

Education

History of Residence for Past Ten (10) Years:
Children Still In Home:
EMPLOYMENT AND INCOME:

** Both adults need to attach a copy of their paystub or W-2 to the completed application.

Education
TOTAL MONTHLY HOUSEHOLD INCOME:

TOTAL MONTHLY EXPENSES:
Budget:

Authorization: Submission of this signed application signifies that Applicant and Applicant’s Spouse authorize Lifeline Children & Family Services to obtain a copy of any consumer or credit report related to this application and to verify any rental history, employment history, or any other information related to this application.

RELEVANT HISTORY:
Adult #1:
If transferring, please complete the following information:
Adult #2:

Have you or any adult living in your home ever applied to any other agency to be a foster parent?

If transferring, please complete the following information:
Both Adults:
Has anyone in your household had difficulties in the following areas?

Name / Condition &Diagnosis / Dates / Treatment & Results

ADDITIONAL PAPERWORK:
In completion of this form you will be contacted by one of our caseworkers for additional paper work.
DISCLAIMER
I hereby declare that the information provided by me in this application for foster parent is true, accurate, and complete to the best of my knowledge. I give my permission for any of this information to be verified and understand that if any of this information is found to be inaccurate or false, this may be used to terminate any further consideration of my application. I give my consent for any agencies, employers, companies, friends, or family members to be contacted.
REFERNCES:
Please list four references that you have known for a minimum of three years.
Please list only those with whom your family is well acquainted and who we may contact:
Reference 1:
Reference 2:

Reference 3:

Reference 4:


Please list the names, addresses, and phone numbers of each adult child not living with you.
Reference 1:
Reference 2:
Reference 3:
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