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Foster Parent Request - Quincy, MA
Your Name (Foster Parent)
*
First
Last
Your Phone Number
*
Your Email Address
*
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?
*
Select Your Agency
*
DCF
JRI
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!
Your Worker's Phone Number
*
How long have you been a foster parent?
*
Please mark the 12Tangibles 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
Back to School Packs - Backpacks filled school supplies to help children succeed in school
Diapers/Wipes/Formula - Basic infant care items needed commonly during transition times
Foster Parent Support Kits - Date night gift cards, coffee, candies and paperwork organization help to bring encouragement to new or overwhelmed foster parents
First Aid Kits - Basic medical supplies to help foster parents care for or welcome in children
Home Safety & Cleaning Kits - Safety & cleaning supplies to help foster parents care for or welcome in children
Car Kits - Portable activities, games and other items to brighten up the time children spend in the car driving to & from visits & appointments
Nothing needed at this time
Please indicate the amount/ages/sizes/gender of the 12 Tangibles that you marked as needed.
*
Do you have a need of clothing from the Foster Care Closet?
*
Yes, I do.
Not at this time.
Please tell us what clothing needs you have. Please, also include each child's gender, clothing size(s) and shoe size.
*
Do you currently have needs that can be met through our First Response program?
*
First Response helps provide immediate needs you may have (mattress & bed, dresser, sheets, blanket, car seat, clothing)
Yes, I do.
Not at this time
What is your desired deadline for the First Response need to be met?
*
48 Hours
4 Days
1 Week
2 Weeks
Description of Need
*
Please select the item(s) you need.
Infant Car Seat
Convertible Car Seat
Booster Car Seat
Highchair
Dresser
Crib (includes mattress)
Toddler Bed (includes mattress & 1 pillow)
Twin Bed (includes frame, mattress, box spring & 1 pillow)
Twin Sheet Set
Twin Comforter or Blanket
Twin Bunk Bed (includes mattresses & 2 pillows)
Two Twin Sheet Sets
Twin Twin Comforters or Blankets
Full Bed (includes frame, mattress, box spring & 2 pillows)
Full Sheet Set
Full Comforter or Blanket
Please include details regarding your need choice(s). (For example: if you requested a twin bed but need 2, indicate that below and/or let us know age, gender, any color request for sheets. We want to make your child feel special!)
Hidden
Do you currently have a foster child(ren) in your home in need of a mentor?
Yes, I do.
Not at this time.
Child's Age
Child's Gender
Does this child desire a mentor?
Yes
No
Would this child's needs be able to be met by a non-professional volunteer?
Yes
No
Describe what type of mentor you are requesting (i.e. age, race, male or female)
Describe days, times, and details of the mentor request. (How often, specific days needed, how long, etc.)
List types of activities you would like the mentor to do with the child (i.e. learn new skill, tutoring, just spending time together, etc.)
Any other information you would like to share with a potential mentor?
Hidden
Do you desire a Support Team through "Families Serving Families"?
The Forgotten Initiative connects local church small groups to foster families through Families Serving Families to provide practical service and relationship support.
Yes, I do.
Not at this time
What kind of support do you need?
Your Support Team will be background checked and finger printed when needed.
Meal Prep & Delivery
Handyman Projects
Help with Transportation
House Cleaning
Babysitting
Respite Care
A Friend/Listening Ear
Please add any additional information you would like to share regarding the support you need through Families Serving Families?
Would you like to be connected to other foster parents in the area?
*
Yes, I give you permission to share my name and contact information.
Not at this time
Any other comments/concerns or needs?
Name
This field is for validation purposes and should be left unchanged.
925
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