Foster Parent Information Sheet - California Family Life Center

930 North,
State St.
Hemet, CA 92543

930 North,
State St.
Hemet, CA 92543

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Location

930 North,
State St.
Hemet, CA 92543

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CFLC – Foster Family Agency
Foster Parent Information Sheet

First Name Last Name

Address1

Address 2

City

State

Zip

Cell#

Select Options

Marital Status:

Please provide the required field.

M

S

D

How Long?

Husband’s DOB:

Wife’s DOB:

Number of Children in Home:

Ages & Gender of Children:

Select Options

Other adults living in home:

Please provide the required field.

Y

N

If so, who?

# Of Bedrooms:

Select Options

Pool/Spa:

Please provide the required field.

Y

N

Select Options

Pets:

Please provide the required field.

Y

N

How many/ Describe?

Select Options

Do you have a valid California Driver License?

Please provide the required field.

Y

N

Select Options

Any unpaid parking tickets?

Please provide the required field.

Y

N

Please Describe:

Employment:

Spouse:

Work #:

Spouse work #:

Select Options

Do you attend church?

Please provide the required field.

Y

N

Which one?

How many foster children desired?

Age Range Desired

Select Options

Gender Preferred

Please provide the required field.

Boys

Girls

No Preference

Referred By:

Questions or Comments

When completed, please return to CFLC Foster Family Agency at the location nearest to you:

Hemet

Fax: 951-654-8586

Indio

FAX: 760-347-2753

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