Foster Forms

Foster Parent Application Forms

• Two Parent Household (City on a Hill attendees)
• Single Parent Household (City on a Hill attendees)

Current Foster Parent Forms

• Extracurricular Activity Log
• Direct Deposit Form
• Reimbursement Form

Back-Up Care Provider Forms

Along with the Release of Information and the Central Abuse Hotline Record Search Application Form, please obtain copies of the potential back-up’s driver’s license and car insurance for transportation.  To schedule a fingerprinting appointment, please contact your Licensing Specialist for assistance.

• Release of Information
• Central Abuse Hotline Record Search Application Form

Re-Licensing Forms

• Form of Responsibility
• Central Abuse Hotline Record Search Application (CSA)
• Community Input Form
• EPSDT
• Confidentiality Agreement
• Affidavit of Civil Rights Compliance (Medical/Emergency Shelter homes only)
• Partnership Plan For Children In Out-Of-Home Care
• Health Certificate
• Discipline Policy
• Fire Arm Safety Affidavit
• Fire Drill Log
• Verification of Income
• Floor Plan/Evacuation Route
• Disaster Preparedness Plan
• Water Safety Affidavit