Name*
Street Address
City, State Zip
Home Phone
Work Phone
Email Address*
Indicate which areas you are interested in:
Receiving CareBecoming a Foster ParentVolunteerCase Aid VolunteerAdoptionRespite CareGiving
Such as from employment, previous volunteer work, or through other activities, including hobbies or sports.
Briefly list your previous volunteer experience.
Name:
Phone:
Email:
Thank you for your interest in our foster care program. We will have an application and other information for those who desire to participate in the program. Please confirm that the information you have given in this form is correct and complete to the best of your knowledge by initialing and dating where indicated below.
Name*: Initials*: Date*:
Our Mission is to see foster children cared for in safe, loving, stable, faith-filled families focused on permanence and stability for the children through restoration of their birth and/or extended families or placement with an adoptive family.
We will do this by providing family and community-based foster care and adoption services utilizing a unique model that provides a nurturing, supportive environment.
The Rose Hill Cottages project is a residential community of 22 homes and community center designed to provide affordable housing to participants in the City Ministries Child Placement Agency and Foster Care program. Our child placement agency will have an office and provides services at the community center.
The City Ministries Child Placement Agency is a faith-based foster care and adoption services agency and an ongoing outreach of City Ministries with the support of Churchome, located at 9051 132nd Ave NE, Kirkland, WA. The agency will license foster homes foster parents, volunteers and provide training and support resources for program participants. The children will be eligible to attend Churchome’s on site pre-school/ kindergarten and participate in programs at the community center.
By initialing and submitting this form, you agree that the information provided is true and correct.
