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Iredell County Department of Social Services FOSTER HOME Application
Be sure to complete the application in its entirety. If a question does not apply, please include N/A.
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Gender:*
1. Male
2. Female
3. Both
Age Range:*
1. 0-3
2. 4-10
3. 11-14
4. 15-18
Number of children:*
Full Legal Name:
Applicant #1*
Applicant #2
Previous Names (including married names):
Applicant #1
Applicant #2
Marital Status:
Applicant #1
Applicant #2
If married, date & place:
Applicant #1
Applicant #2
Date of birth:
Applicant #1
Applicant #1
Applicant #2
Applicant #2
Place of birth (city & state):
Applicant #1
Applicant #2
Race:
Applicant #1
Applicant #2
Gender:
Applicant #1
Applicant #2
Occupation:
Applicant #1
Applicant #2
Employer:
Applicant #1
Applicant #2
Annual salary:
Applicant #1
Applicant #2
Work schedule (example 8am-5pm):
Applicant #1
Applicant #2
Highest grade completed:
Applicant #1
Applicant #2
How long have you lived in Iredell County?
Applicant #1*
Please specify the number of years you have lived in Iredell County.
Applicant #2*
Please specify the number of years you have lived in Iredell County.
Applicant #1 - Where did you reside prior to residing in North Carolina?*
Applicant #2 - Where did you reside prior to residing in North Carolina?*
Home address (street, apartment number, etc.):*
City:*
State:
Zip code:*
Email address(es):*
Telephone numbers:
Home or main contact #*
Work #
Cellphone #1
Cellphone #2
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Foster Care Questions
How will you help support the reunification process between the foster child placed in your home and his/her family? *
How will you prepare yourself and your family to cope when a child who you have been fostering is returned to their birth family? *
What comfort level do you have in working directly with the foster child’s birth parents or extended family? *
Why are you interested in becoming a foster family? *
How did you hear about us? *
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By checking the following box, I certify that the information provide on this application is correct to the best of my knowledge. I also authorize the Iredell County Department of Social Services to conduct criminal checks on myself and members of my household.
*
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