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Adopt foster form test page

 

    Personal Details Applicant 1

    Full Legal Name (required)

    Birth Name

    Previous Names

    Preferred Name

    Pronouns

    Birth Date (Required) (yyyy-mm-dd)

    Place of Birth

    Gender

    Ethnic Origin

    Racial Origin (required)

    Citizenship

    Religion

    Education

    Language(s) Spoken

    Occupation

    Employer

    Native Band Name/No.

    Cell Phone

    Work Phone

    May we contact you at work? (required)
    YesNo

    Personal Details Applicant 2

    Full Legal Name

    Birth Name

    Previous Names

    Preferred Name

    Pronouns

    Birth Date (yyyy-mm-dd)

    Place of Birth

    Gender

    Ethnic Origin

    Racial Origin

    Citizenship

    Religion

    Education

    Language(s) Spoken

    Occupation

    Employer

    Native Band Name/No.

    Cell Phone

    Work Phone

    May we contact you at work?
    YesNo

    Address Line 1

    Address Line 2

    City

    Province

    Postal Code

    Home Phone

    Can a message be left?
    YesNo

    Email Address (Required)

    Children and other members of household:

    Children in Household:

    Name Gender Birthdate (yyyy-mm-dd) Lives With Racial/Ethnic Origin FNIM*

    *FNIM=First Nations Inuit Metis

    Other adults living in applicant(s) home

    Name Gender Birthdate Relation to Applicant(s)

    Marriage or Domestic Partnership

    Current Marriage Date (yyyy-mm-dd)

    Current Domestic Partnership Date (yyyy-mm-dd)

    Applicant 1 Past Marriage or Domestic Partnership         Applicant 2 Past Marriage or Domestic Partnership        
    Date Begun (yyyy-mm-dd)     Date Ended (yyyy-mm-dd)    
    Date Begun (yyyy/mm/dd)     Date Ended (yyyy-mm-dd)    

    Present Application

    Tell us what you are interested in (please check all that apply)

    Adopt at Children's Aid Society
    Adopt at Children's Aid Society but also interested in fostering
    Adopt Privately
    Foster Parent Adopting Foster Child
    Fostering and Adopting
    Fostering
    Wanting to Foster or Adopt a Specific Child

    Type of child you are considering parenting (the following section is required)

    Age of Child (or age range)
    Gender of Child MaleFemaleAnyBoth
    Race/Ethnic Origin of Child
    Are you considering adopting or Fostering siblings? YesNoUnsure

    Previous Applications/Child Welfare Involvement (the following section is Required)

    Have you previously applied to adopt or foster
    either as an individual, a couple or in a previous relationship?    		 YesNo
       
    Have you previously started or completed an adoption
    or fostering education program?    		 YesNo
       
    Have you previously started or completed
    a homestudy assessment?    		 YesNo
       
    Have you previously been involved with a Children's Aid Society
    or any protection authority outside of Ontario?    		 YesNo
    If "Yes", please provide specifics:

    Additional Comments

    Any additional information or comments:

    Acknowledgements

    I/We the undersigned, submit this application with the following acknowledgements:

    1. I/We acknowledge that the process of adoption by Ontario residents is governed by the Child and Family Services Act (CFSA), and the Intercounty Adoption Act (IAA). We acknowledge that the process of fostering is governed by the Child & Family Services Act and Foster Care Licensing Regulations.
    2. I/We acknowledge that our worker's role is to ensure the best interests of any child who may be placed with me/us when assessing the suitability and eligibility of applicant(s). The worker's recommendation does not guarantee approval by the Children's Aid Society in public adoption, the Ministry of Children and Youth Services in Private and International Adoption of Canada Immigration in International adoption, nor the eventual placement of a child in my/our family. We further acknowledge that the worker's recommendation does not guarantee approval to provide foster care.
    3. I/We give full permission to our worker to communicate and exchange information about me/us, in written or verbal form, with other children's aid societies, child protection authority outside of Ontario, private and international adoption agencies, physicians, mental health professionals, referees, other adoption licensees and practitioners, government agencies/departments, and other sources, as necessary, in order to further my/our application. We also give permission for our worker to search required electronic databases to complete the assessment.
    4. I/We understand that any false statement or omitted information in this application may jeopardize my/our application.
    Applicant 1 Acknowledgement (Required) Applicant 2 Acknowledgement

    Please take a moment to tell us about where you heard about fostering/ adoption.

    Radio Ad; Specify
    Television Ad; Specify
    Television Program; Specify
    Newspaper Ad;Which ad and in which newspaper
    Newspaper Article; What was the article about and which newspaper?
    Agency Website
    Agency Pamphlet or Handout: Specify
    Social Media (Facebook, Twitter Instagram etc); Specify
    Word of Mouth; Specify
    Personal Involvement; Specify
    Community Event; Specify

    Other; Specify