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Foster Parent Application

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MM slash DD slash YYYY
A1 - Full Legal Name
A1 - Other Names Used
A1 - Address(Required)
A1 - Sex(Required)
MM slash DD slash YYYY
A1 - Citizenship(Required)
A1 - NC Resident(Required)
A1 - Currently employed(Required)
A1 - Employed
Select date MM slash DD slash YYYY
A1 - Military Service(Required)
A1 - Married(Required)
A1 - Have you ever been separated?

Section Break

MM slash DD slash YYYY
Address same as above?
A2 - Have you ever been separated?
A2 - Address
A2 - Currently Employed(Required)
A2 - Employed
Select date MM slash DD slash YYYY
A2 - Military Service(Required)
Does anyone in the home have pending criminal charges or any pending restraining or domestic violence orders against them?(Required)

Will all persons over the age of eighteen be willing to submit to a criminal check and fingerprinting?(Required)
Will all persons over the age of eighteen be willing to submit to a criminal check and fingerprinting?(Required)
Which ages are you the most interested in fostering?
Which of the following are you most interested in?
Preferred Gender(Required)
Do you own or Rent(Required)
Which type of home?(Required)
Applicant 1 - I/we hereby certify that all the information herein is true and complete(Required)

I/we hereby certify that all the information herein is true and complete to the best of my/our knowledge. II/we give permission for a representative of Carolina Adoption Services to contact the references listed above, as well as perform any background checks necessary in the application process herein. In completing this application to Carolina Adoption Services, I/we understand that there is no commitment by the agency to approve my/our home for the placement of a child(ren). We further understand that I/we are not employees of Carolina Adoption Services, but are Independent Contractors responsible for all reports to Federal and State Agencies regarding earnings paid by Carolina Adoption Services. We further understand that, with our permission, the agency will contact officers and agencies, as needed, to collect information related to foster home licensing.

Applicant 2 - I/we hereby certify that all the information herein is true and complete

I/we hereby certify that all the information herein is true and complete to the best of my/our knowledge. II/we give permission for a representative of Carolina Adoption Services to contact the references listed above, as well as perform any background checks necessary in the application process herein. In completing this application to Carolina Adoption Services, I/we understand that there is no commitment by the agency to approve my/our home for the placement of a child(ren). We further understand that I/we are not employees of Carolina Adoption Services, but are Independent Contractors responsible for all reports to Federal and State Agencies regarding earnings paid by Carolina Adoption Services. We further understand that, with our permission, the agency will contact officers and agencies, as needed, to collect information related to foster home licensing.