Family Nomination Form

Family Nomination Form
Our Mission as Foster Accountability

To create tools that help foster and kinship parents establish better relationships, teach, and spend quality time nurturing and caring for the children in their care in order to make an impact in their lives, which ultimately changes the experience of foster care.
The Foster Accountability Gift Shop

Our gift shop is a carefully curated collection of our one-of-a-kind experience gift boxes. Each box includes a selection of items that follow a specific theme – Inspiration, Self-care, Black History, Learning, & More – and offers unique ways to make a gifting occasion extra memorable. Whether it’s giving kids the tools to get creative through learning or helping adults express their emotions in a healthy way.
We are looking for Foster Families to bless with our unique tools and gifts that are donated from our customers: Donated gifts could be for children or even adults. Our gift donations are not limited to only foster children, but bio children that are in the home as well. Some gift donations may be for a caregiver as well. Nominees will be chosen based on the number of donated gifts available. For example, if we have two gifts available and there are three children in the home, we will consider a family that has three children first. All nominees are not guaranteed a gift, nominees will be randomly chosen whenever a gift has been donated. If you have a foster family you would like to nominate, please complete the form below:
REFERRAL
Date of Form Submission

Month Day Year
Date
Referral Name:

First Name Last Name
Email:
example@example.com
NOMINATED FAMILY
Head of Household Name: *

First Name Last Name
Head of Household Email: *
example@example.com
Number of Family Members: *
Number of Adults: *
Number of Children: *
Parent / Guardian #1 *

First Name Last Name
Male or Female (this helps us determine which gift type to consider the nominee for) *

Female Male
Parent / Guardian #2

First Name Last Name
Male or Female (this helps us determine which gift type to consider the nominee for)

Female Male
Child #1 First Name: *
Age *
Male or Female (this helps us determine which gift type to consider the nominee for) *

Female Male
Child #2 First Name:
Age
Male or Female (this helps us determine which gift type to consider the nominee for)

Female Male
Child #3 First Name:
Age
Male or Female (this helps us determine which gift type to consider the nominee for)

Female Male
Child #4 First Name:
Age
Male or Female (this helps us determine which gift type to consider the nominee for)

Female Male
Child #5 First Name:
Age
Male or Female (this helps us determine which gift type to consider the nominee for)

Female Male
Child #6 First Name:
Age
Male or Female (this helps us determine which gift type to consider the nominee for)

Female Male
Child #7 First Name:
Age
Male or Female (this helps us determine which gift type to consider the nominee for)

Female Male
Child #8 First Name:
Age
Male or Female (this helps us determine which gift type to consider the nominee for)

Female Male
Child #9 First Name:
Age
Male or Female (this helps us determine which gift type to consider the nominee for)

Female Male
Child #10 First Name:
Age
Male or Female (this helps us determine which gift type to consider the nominee for)

Female Male
If there are more than 10 children in the home, please list here.
Why would you like to see this foster family receive our gift?
How would receiving one of our gifts help this foster family in their journey?
Is there anything else you would like us to know about this foster family?
We love pictures of families with our gifts - both to celebrate and to encourage support of future families. Would your nominated family be comfortable sharing photos and videos of them with our gifts?
We know that foster families cannot have their faces exposed and understand that pictures sent will either need to be from the back or emoji's covering the faces.
RESIDENTIAL INFORMATION
Mailing Address of where the gift should be shipped to:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
WE HAVE A MATCH!
Next Steps: Foster Accountability Gift Shop Team will review nominations and select families based on the gift donations available. What can the family expect: The chosen family will receive an email congratulating them on their gift. We will confirm the address where the gift item(s) will be shipped.

Thank you for your time in completing this n form and for allowing us to serve foster families a the country.

- The Foster Accountability Gift Shop Team
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Family Nomination Form

Our Mission as Foster Accountability

The Foster Accountability Gift Shop

REFERRAL

NOMINATED FAMILY

RESIDENTIAL INFORMATION

WE HAVE A MATCH!