REGISTER

*	Title	First Name	Second Name	DOB

* Plese select which applicant has made the enquiry

Relationship: Single Married Separated Divorced Living together
If a joint enquiry / application, please state length of relationship: Years Months
* How many other people live in the household:
* Address:
* Postcode:
* Telephone (home): Telephone (work):
Can you be contacted at work?: Yes No
* Mobile:
* E-mail address:
Do you have a spare bedroom? Yes No
* Why do you want to foster?
Are you looking at this as a full time career? Yes No
* What age and range of children do you want to look after:

Does anyone in the household smoke? Yes No
If yes, who and how many a day?

Due to the new smoking regulations the agency will be looking to recruit carers who are prepared to cease smoking. If currently smokers they would then need think discussing a cessation programme with their GP.

* How/Where did you hear of Team Fostering:
Additional Information: Do you have experience of caring for your own or other people's children: Yes No
If yes:- Childminding Foster care / Adoption Residential work
Youth work Teaching Parenting

other (please state):
if yes to fostering / adoption, for how long and who with?