Foster Care Complete Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Information Package – Step 1 of 4Foster Carer Information BrochureRead the information package *I’ve read the information packageNextThank you for your interest in becoming a foster carer with Pathfinders! If you would like to take the next step towards becoming a foster carer, please complete this form and a health checklist for each applicant and return all forms to Pathfinders. Once we have received your forms, we will contact you to arrange an initial home visit. This visit allows us to meet you and exchange information about foster caring. Home visits are also an opportunity for us to complete a ‘Home Safety Inspection Check’, where we assess the suitability of your home environment for foster care. Prior to receiving approval as a foster carer, applicants are required to be involved in an assessment process that includes face-to-face sessions, group training, background checks, and a home safety check.Registration of Interest in being a Foster CarerI/we have read the Information Pack for potential carers, including “Matthew’s story” and (mark one) I/we would like to be contacted by a worker from Pathfinders to arrange a home visit.I/we have already arranged a home visit with Pathfinders.Date / Time of home visitDateTimeName *FirstLastMr/MrsMrMrsMsDrPartner's NameFirstLastMr/Mrs (partner)MrMrsMsDrAddressAddress Line 1CityState / Province / RegionPostal Code— Select country —AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryPhone *Email *Number of Family membersInclude all adults, young people and children regularly living in your home or residing on your property on a regular or frequent basis, including in a caravan, vehicle or any other structure.Name 1 *FirstLastGender 1DOB 1Relationship 1Relationship to partner 1Name 2 *FirstLastGender 2DOB 2Relationship 2Relationship to partner 2Name 3 *FirstLastGender 3DOB 3Relationship 3Relationship to partner 3Name 4 *FirstLastGender 4DOB 4Relationship 4Relationship to partner 4Other family members detailsType of care you are interested inKinship CareEmergency CareRestoration CareLon-term CareHigh needs CareRespite CareFostering with a view to guardianshipFostering with a view to adoptionTo read a description of the different types of foster care options please check our foster care page.Signature * Clear Signature Partner Signature Clear Signature NextDisclosure and Privacy Notice Pathfinders is collecting the personal information on this form for the purpose of assessing the applicant for consideration to become an approved foster carer. Your personal information will be treated in accordance with the Privacy and Personal Information Protection Act 1998. Note: Each applicant is required to complete a separate Health ChecklistNumber of Applicants *Applicant DetailsApplicant 1 NameFirstLastDo you have any illness/es or physical condition/s?YesNoIf you have answered YES, please provide details of your illness or physical condition:Do you have any psychological or mental health condition/s?YesNoIf you have answered YES, please provide details of your psychological or mental health conditions:Have you seen any medical specialists in the past three years?YesNoIf you have answered YES, please provide details of the: name of specialist(s), type of specialist(s), and reason for seeing specialist(s):Do you use any prescription medication(s)?YesNoIf YES, provide details for each medication: name of medication and dosage, reason for use, length of use.Signature * Clear Signature Applicant 2 DetailsApplicant 2 NameFirstLastDo you have any illness/es or physical condition/s?YesNoIf you have answered YES, please provide details of your illness or physical condition: Do you have any psychological or mental health condition/s?YesNoIf you have answered YES, please provide details of your psychological or mental health conditions:Have you seen any medical specialists in the past three years?YesNoIf you have answered YES, please provide details of the: name of specialist(s), type of specialist(s), and reason for seeing specialist(s):Do you use any prescription medication(s)?YesNoIf YES, provide details for each medication: name of medication and dosage, reason for use, length of use.Signature Applicant 2 * Clear Signature NextUpdating preview…This is a preview of your submission. 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