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Prospective Foster Parent Application

Applicant Information
First Name *
Last Name *
First Name *
Last Name *
Country
Address Line 1 *
Address Line 2
City *
State/Province *
Postal Code *
ext Extension
Current Marital Status
Do you have a Social Security or valid ITIN number?
Home Information
Type of residence
Do you own your home?
If you rent, would a landlord approve of foster children in your residence?
Family Information
Are any of these children specialized?
Do any adults reside in your home?
Vehicle Information
Do you own a vehicle, drive and have a valid Illinois driver's license and automobile insurance?
If married, do both have above?
Experience
Are you currently licensed as a foster parent?
If no, have you ever fostered before?
Do you currently have children placed in your home?
Have you fostered any children besides the ones described above?
Have you ever fostered children with special needs?
Have you completed Foster Parent Pride?
Do you have a certificate?
Employment Information
Are you able to provide proof of income in the form of 3 recent pay stubs and tax information from the previous year?
Are you able to provide proof of income in the form of 3 recent pay stubs and tax information from the previous year?
Do you pay your own utility bills (lights, gas, etc)?
If so, will you be able to provide a copy of them to us? They must be in your name.
Additional Information
Is your household vaccinated against COVID-19?
Disclaimer And Signature

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to acceptance as a foster parent at UCP Seguin of Greater Chicago, I understand that false or misleading information in my application or interview may result in my release.

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