Date
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Month
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Day
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Date
Applicant 1 Full Name (including maiden)
Applicant 2 Full Name (including maiden)
Full Home address, Street number and name, city and zip code
Home telephone number
How long have you resided in the State of Oklahoma?
Applicant 1 cell number
Applicant 2 cell number
Email address
example@example.com
Email Address
Names and age of children (please indicate if they live in your home)
How were you referred?
Annual Household income
Applicant 1: Have you ever been arrested, have any type of criminal record, or child welfare history?
If yes, please explain
Applicant 2: Have you ever been arrested, have any type of criminal record, or child welfare history?
If yes, please explain
Do you have a history of adoption or foster care? If so, please describe briefly.
What is your perspective of a child's biological parents?
What is your motivation to become foster parents?
Any other comments or information you would like to add
Applicant 1 Signature
Date
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Month
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Day
Year
Date
Applicant 2 Signature
Date
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Month
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Day
Year
Date
Date Pre Application Received- Agency use ONly
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Month
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Day
Year
Date
Date Reviewed by Director
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Month
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Day
Year
Date
Pre approval Date
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Month
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Day
Year
Date
Foster Care Specialist Assigned
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