Foster Parent Request Form - Bloomington, IL

Your Name (Foster Parent)*

First Last

Your Phone Number*

Your Email Address*

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Delivery Address*

We respect your privacy and would never share your name or location except for delivery purposes.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Do you have a church you attend regularly?*

Please note, regardless of church affiliation we are here to serve you!

Yes
Not at this time

What church do you attend?*

This helps us advocate for more support for foster families attending your local church.

Select Your Agency*

Your Worker's Name*

First Last

Your Worker's Email Address*

After completion of this form, a copy of the form will be emailed to your worker to keep them in the loop! *TFI receives a large volume of request and this helps us validate who is or isn't a current foster parent.

TANGIBLES

Please mark the Tangibles that you are currently in need of:*

Journey Bags - Diaper bags, backpacks, or duffel bags with personal & comfort items for children in foster care to call their own at the time of placement
Home Safety Items - Items needed commonly during transition times
Home Cleaning Kits - Cleaning supplies to help foster parents welcome in children
Nothing needed at this time

Journey Bags

Diaper bags, backpacks, or duffel bags with personal & comfort items for children in foster care to call their own as they come into care.

The agency will often distribute Journey Bags at the time of placement, but if the child(ren) didn't receive one, you may request one here.

What size Journey Bags do you need in GIRL bags?*

What size Journey Bags do you need in BOY bags?*

If you need multiple bags of the same size & gender, please indicate that here.

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Home Safety Items

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Select Home Safety Items Needed:*

Baby Gate
Night Lights
Outlet Covers
Door Knob Safety Covers
Cabinet Latches
Door Latches

FIRST RESPONSE

Do you currently have needs that can be met through our First Response program?*

First Response works to meet the immediate needs of children transitioning into or out of foster care (mattress & bed, bedding, car seat, etc.).

Please Note: We are unable to provide these items for licensing purposes. This program meets the needs of children during their transition into a foster home or during reunification.

Yes, I do.
Not at this time

Desired deadline for the need to be met:*

48 Hours
4 Days
1 Week
2 Weeks

Urgency Level

!!!: Absolutely need this by the desired deadline
!!: Prefer by the desired deadline, but there is wiggle room
!: Flexible on the date, it will be a blessing whenever we can get it

Description of Need*

Please select the item(s) you need.

Car Seat(s)
Bed(s)
Bedding

Name

First Last

We are collaborating with Kern Mattress Outlet (KMO) to provide mattresses, boxsprings, and bedframes for children in foster care/intact families. They have graciously agreed to provide the mattresses, boxsprings, and delivery to local families. We can make additional accomodations for out of town families/bed frame needs if they are present. We need to get permission from your caseworker to make this arrangement. If you choose not to provide this info, we will have you/ your caseeworker reach out to KMO directly to arrange a pickup time.

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

First Response | Car Seat Specifics

What kind of car seat(s) are needed?*

Infant Car Seat (5-22 lbs.)
Convertible Car Seat (5-22 lbs. rear-facing OR 20-65 lbs. forward-facing)
Boost Car Seat (40-65+ lbs.)

Quantity of Infant Car Seats Needed:*

Quantity of Convertible Car Seats Needed:*

Quantity of Booster Car Seats Needed:*

First Response | Bed(s) & Mattress(s) Specifics

What bed size(s) is/are needed?*

Crib
Toddler Bed
Twin Bed
Bunk Bed - Twin (Please Note: Bunk beds are to only be requested for children 4 years and older.)

Quantity of Cribs Needed:*

Quantity of Toddler Beds Needed:*

Quantity of Twin Beds Needed:*

Quantity of Bunk Beds (twin) Needed:*

What is needed for the bed(s) you selected?*

Bed Frame
Mattress

First Response | Bedding Specifics

What size bedding is needed?*

Crib
Toddler Bed
Twin Bed
Bunk Bed - Twin

What bedding is needed for the bed(s) selected?*

Pillow
Sheets
Blanket/Comforter

Please give us more information about each individual needing bedding.*

(Click (+) to add more rows/individuals)

Gender	Size Bedding Requested	Favorite Color	Favorite Characters/Interests

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Email

This field is for validation purposes and should be left unchanged.

Foster Parent Request - Bloomington, IL

TANGIBLES

Journey Bags

Home Safety Items

FIRST RESPONSE

First Response | Car Seat Specifics

First Response | Bed(s) & Mattress(s) Specifics

First Response | Bedding Specifics

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