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Foster Parent Inquiry

Parent #1 -- Home Address -- Parent #2 -- Inquiry

Home Address

Address1:

Address2:

City:

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Inquiry
Area of Interest:	*
Have you ever been licensed as a foster/adoptive home? * If yes, thru what agency?
Date last licensed?	(MM/DD/YYYY)
How did you hear about NYAP? *
If other, please specify
What is your experience working with children other than your own?
Comments:
Age range of youth interested in? (check all that apply) *required 0-5 years 6-10 years 11-15 years 16-18 years any
Gender of youth interested in?
Number of youth interested in?
Would you be interested in caring for sibling groups?
Other Comments:
I understand NYAP is a treatment foster care agency I understand *Please check to proceed
I understand that all adult members of my household will be required to have a criminal background check before I can be licensed I understand *Please check to proceed
I understand I am eligible to adopt at age 18, but must be at least 21 to be a foster caregiver I understand *Please check to proceed

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