Foster Family Interest Form

Applicant Name:
Address:
City:
State:
Postal Code:
Cell Phone:
Work Phone:
Home Phone:
Email Address:*
How Did You Learn of Community Care Alliance?:
Are you at least 21 years of age?:
Do You Have a Valid RI Driver’s License?:
Do You Have Reliable Transportation?:
Do You Have Appropriate Space for a Foster Child? (50 square feet/child):
Do You Have a Spare Bed for the Foster Child?:
Are You Financially Stable without Reliance on the Foster Care Board Rate?:
What is Your Current Work Schedule/Other Commitments?:
Are you able to communicate in English?:	Yes No
Are you Bilingual?:
Do You Have Smoke Detectors?:
Do You Have Fire Extinguishers?:
Do You Have a Remote Boiler Switch?:
Have You Ever Applied to Become a Foster Parent with Another Agency?:
If Yes, Please List:
Please List All Household Members and Their Ages:
Additional Information that you would like to share:














Enter the code shown above
Submit
* Required

401.235.7000

PO Box 1700 | Woonsocket, RI | 02895 | Directions
401.235.7000 Main Agency | 401.235.7120 Emergency

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