_____________________________ _______________________________________ _______ Applicant 1 Printed Name Signature Date _____________________________ _______________________________________ _______ Applicant 2 Printed Name Signature Date Considerations for Placing Agency Provide additional information that may be beneficial for a placing agency to consider before placing a with the family. Capacity Age Range to Gender Male Female Emergency Shelter Care or Ethnicity of Children Languages able to speak Behaviors Religion * Indicate if family is approved for only the children currently placed. Confidential List of Foster Children This page is to remain confidential and is not to be attached to copies of the Written Child #1: Insert Name of Child Date Placed: Child #2: Insert Name of Child Date Placed: Child #3: Insert Name of Child Date Placed:
_____________________________ _______________________________________ _______ Applicant 1 Printed Name Signature Date _____________________________ _______________________________________ _______ Applicant 2 Printed Name Signature Date Considerations for Placing Agency Provide additional information that may be beneficial for a placing agency to consider before placing a with the family. Capacity Age Range to Gender Male Female Emergency Shelter Care or Ethnicity of Children Languages able to speak Behaviors Religion * Indicate if family is approved for only the children currently placed. Confidential List of Foster Children This page is to remain confidential and is not to be attached to copies of the Written Child #1: Insert Name of Child Date Placed: Child #2: Insert Name of Child Date Placed: Child #3: Insert Name of Child Date Placed:
resource_family_written_report.docx