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Form #721

Family Home Information

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Family Home Information - free form to use

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Family home information.

I. Name: Applicant A _________

Applicant B _________

Address _________

Telephone ( ) _________

How long have you been a resident of _________? Applicant A: _________

Applicant B: _________

II. Home—Check any that apply

Do you —Own —Rent Landlord approval to care for unrelated children —Yes —No

—Apartment

—Mobile Home —House —Other

Water supply

—City —Other (Specify) _________

 

Directions for reaching your home _________

III. Marital Status—Check One

—Married

Date _________

 

—Single

—Widowed

 

—Divorced

—Separated

 

 

 

Previous marriage: Check if yes

 

 

—Applicant A —Applicant B

 

IV. Members of Household

(Include Children, Relatives, Others)

Name _________

Relationship Appl. A/Appl. B _________

Birthdate _________

Languages spoken _________

Religion _________

V. Current employment

Applicant A

Name of Firm _________

Address _________

Title or Position _________

Hours _________

Years Employed _________

Applicant B

Name of Firm _________

Address _________

Title or Position _________

Hours _________

Years Employed _________

Approximate annual income of total household, regardless of source _________

If both applicants or single applicant work outside of home, describe child care plans: _________

VI. Describe your experience with children other than your own. These may include care of relatives' children, teaching Sunday School, work with Scouts or other groups, etc. _________

Why do you want to provide child care? _________

State the age range, sex, and number of children you would like to have in your home: _________

VII. References: Persons unrelated to you who know how you care for children.

1.

Name _________

Phone _________

 

 

Address _________

City _________

Zip Code _________

2.

Name _________

Phone _________

 

 

Address _________

City _________

Zip Code _________

3.

Name _________

Phone _________

 

 

Address _________

City _________

Zip Code _________

 

VIII.  Comments are welcome: _________

I/We certify that the above information is true. I/We understand that making materially false statements in order to obtain a license or permit constitutes a Class A misdemeanor and that I/We may be prosecuted for such misconduct.

Signature(s) _________

_________

 

Date _________

 

Contributed by
Asian Investment Advisers
 
Name of Firm Asian Investment Advisers
Total Forms Contributed 61
 

See All Asian Investment Advisers's Forms
 

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Terms Of Use

Submissions to this site, including any legal or business forms, posts, responses to questions or other communications by contributors are not intended as and should not be construed as legal advice. You are strongly encouraged to consult competent legal council before engaging in any action based upon content contained on this site.

These downloadable forms are only for personal use. Retransmission, redistribution, or any other commercial use is prohibited. This includes reposting forms from this site to another site offering free legal or other document forms for download.

Please note that the donator may have included different usage terms regarding this form, and you agree to abide by these terms. It is highly recommended that you have a licensed attorney review any legal documents for which you are searching in order to make sure that your needs are being properly and completely satisfied.

Your use of this site constitutes your acceptance of our terms of use and your agreement to hold this site, its officers, employees and any contributors to this site harmless for any damage you might incur from your use of any submissions contained on this site. If you do not agree to the above terms, please do not proceed.

These forms are provided to assist business owners and others in understanding important points to consider in different transactions. They are offered with the understanding that no legal advice, accounting, or other professional service is being offered by these documents or on this website. Laws vary in the different states. Agreements acceptable in one state may not be enforced the same way under the laws of another state. Also, agreements should relate specifically to the particular facts of each situation. Therefore, it is important to consult legal counsel whenever utilizing these forms. The Forms are not a substitute for legal advice YourFreeLegalForms.com is not engaged in recommending or referring members on the site or making claims about the competence, character or qualifications of its participating members.
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Comments

submitted 10/25/2008
by DavidMarshall  

"If you want to act as a foster parent and your home is suitable, you can apply to the state for acceptance into their scheme. The process involves you giving reasonably comprehensive information about your family and its circumstances. You should also think carefully about how many children you might be able to help. The state will then investigate your background and, if you are considered a suitable candidate, license you to accept children into your home. Because of the general threat posed by pedophiles, the state takes its responsibility to vet you seriously and, if you are less than honest in the information you give in this form, you can be prosecuted."
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