Foster Parent Application Form

Thank you for your interest. If you have any questions before beginning your application or at any point during the application process, please do not hesitate to contact the Department of Social Supports and Well-Being at fosterafuture@gov.nl.ca or call toll free 1-855-683-8111. A social worker is available to assist you during regular office hours, Monday to Friday, 8:30am to 4:30pm.

"*" indicates required fields

Step 1 of 5

20%

Please note that you will be required to enter 3 references at the end of this application form.

Part A: Applicant

Last Name*

Given Name(s)*

Also known as (including all previously used names)

Street Address*

Address Line 1 Address Line 2 City/Town Province Postal Code

Home Phone

Cell Phone

Email Address

Is the mailing address different from the street address above?

Yes

Mailing Address*

Address Line 1 Address Line 2 City/Town Province Postal Code

Date of Birth*

YYYY dash MM dash DD

Place of Birth

Education

Are you employed?*

Yes

What is your place of employment?*

Occupation/Position (include schedule where applicable):*

Formal training and / or experience working with children and youth:

Any other training (first aid, suicide intervention, etc.):

Are you willing to participate in ongoing training?*

Yes

Have you ever been involved in any criminal activity and / or charged with a criminal offence?*

Yes

Please explain:*

Do you have a health issue (physical or mental health) that would impact your ability to care for a child/youth?*

Yes

Please explain:

Part B: Co-Applicant (if applicable) E.g., spouse, common-law partner, significant other

Add another Applicant?*

Yes

Last Name*

Given Name(s)*

Also known as (including all previously used names)

Street Address*

Address Line 1 Address Line 2 City/Town Province Postal Code

Home Phone

Cell Phone

Email Address

Is the mailing address different from the street address above?

Yes

Mailing Address*

Address Line 1 Address Line 2 City/Town Province Postal Code

Date of Birth*

YYYY dash MM dash DD

Place of Birth

Education

Are you employed?*

Yes

What is your place of employment?*

Occupation/Position (include schedule where applicable):*

Formal training and / or experience working with children and youth:

Any other training (first aid, suicide intervention, etc.):

Are you willing to participate in ongoing training?*

Yes

Have you ever been involved in any criminal activity and / or charged with a criminal offence?*

Yes

Please explain:*

Do you have a health issue (physical or mental health) that would impact your ability to care for a child/youth?*

Yes

Please explain:*

Part C: Family Information

Children of the applicant(s)

Name

Date of Birth

Gender

Living at Home

How did your family become aware of the foster care program?*

Family/Friend

Public Service Announcement

Radio

Website

Facebook/Instagram

YouTube

VOCM website

Metrobus

Digital Sign

Other

Other*

How long has your family been thinking about fostering?*

Less than six months

More than a year

About a year

Other

Other*

Have you spoken to anyone about fostering?*

Yes

Who did you speak with?*

Foster Families Newfoundland and Labrador

A foster parent

Other

Other*

What are your family's expectations of caring for children/youth in care?*

What impact may fostering have on your family and lifestyle? Please explain.*

Are you willing to use your own vehicle in your role as Foster Parent?*

Yes

I don't own a vehicle

Part D: Matching Children/Youth

For which age group are you interested in providing care?*

No age preference

Infant up to 2 years

2-5 years

6-11 years

12-16 years

Please explain:*

Do you have a preference for the sex of the child/youth that you are interested in providing care for? Please explain.*

Part E: References

Name three (3) references, their complete mailing and street addresses, and telephone numbers. Reference requirements include that the reference be a non-relative, have known your family for a minimum of three (3) years, and have a relationship with your family that includes in-home contact.

Reference #1

Last Name*

Given Name(s)*

Residential Address*

Street Address Address Line 2 City/Town Province Postal Code

Home Phone

Cell Phone

Email Address

Is the mailing address different from the residential address above?

Yes

Mailing Address*

Address Line 1 Address Line 2 City Province Postal Code

Reference #2

Last Name*

Given Name(s)*

Residential Address*

Street Address Address Line 2 City/Town Province Postal Code

Home Phone

Cell Phone

Email Address

Is the mailing address different from the residential address above?

Yes

Mailing Address*

Address Line 1 Address Line 2 City Province Postal Code

Reference #3

Last Name*

Given Name(s)*

Residential Address*

Street Address Address Line 2 City/Town Province Postal Code

Home Phone

Cell Phone

Email Address

Is the mailing address different from the residential address above?

Yes

Mailing Address*

Address Line 1 Address Line 2 City Province Postal Code

Any other information or comments you feel are important to include:

Does the individual confirm that information is complete and correct?*

Yes

I confirm that I have obtained consent from the individuals listed as references to share their personal information with the Department for the purpose of this application.*

Agree

Privacy Statement: The personal information collected in this form will be used only for the administration of those programs provided by the Government of Newfoundland and Labrador for which the supplier is a participant. This information is being collected for the purposes of the care and protection of children and youth in accordance with s.90 and s.91 of the Children, Youth and Families Act and with section 61(c) of the Access to Information and Protection of Privacy Act, 2015. All information provided will be maintained in a secure manner and confidentiality will be protected, as required by ATIPPA, 2015. For questions or comments related to the protection of your personal privacy, please contact the Foster Care Intake Social Worker at fosterafuture@gov.nl.ca.

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Foster Parent Application Form

Part A: Applicant

Part B: Co-Applicant (if applicable) E.g., spouse, common-law partner, significant other

Part C: Family Information

Part D: Matching Children/Youth

Part E: References