Fostering Enquiry

Name *

Email Address *

Phone number *

Address *

Applicant gender *

Male
Female
Other

Date of birth *

/ Date of birth (mandatory field) month / Date of birth (mandatory field) year

Nationality *

Ethnicity *

White British
White Irish
Any other white background
White and Black Caribbean
White and black African
White and Asian
Any other mixed background
Indian
Pakistani
Bangladeshi
Tamil
Any other Asian background
Caribbean
African
Any other black background
Chinese
Any other ethnic group
Declined to say

Religion *

I'm applying as a *

Single carer
Part of a couple

I/We have a spare bedroom which is available full time for a foster child

Yes No

I've some flexibility for day time care for a child

Yes No

How have you heard about fostering? (tick all that apply) *

Council referral
External sign eg Bus stop ad
Council Facebook
Council Twitter
Radio advert
Local newspaper
Leaflet
Email
Other newspaper/magazine
Search engine
Poster in library/school/surgery/hospital
Word of mouth/friend/family