Variety Children and Family
Donation
Foster Family Home Application 102F

Programs
Foster Family Home Application 102F

VARIETY  CHILDREN & FAMILY SERVICES 

FOSTER  FAMILY  HOME APPLICATION 102 F

I/We  here by authorize Variety Children & Family Services to obtain reports on my/our financial activities and background. I/We  understand  that any misrepresentation on this application forms whether intentional or not are ground for revocation of my/our  application and subsequent decertification if already licensed as a foster parent. I/We declare under penalty of perjury and under the child protection laws of Sierra Leone that the statements on this forms are true and correct to the best of my/our knowledge. 

Foster Home Application 103 F
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Alcoholism
Seizure Disorder
Heart Condition
Mental Illness
Use of Narcotics
Tuberculosis
Serious Physical Injury
Applicant Signature
Date
Co-Applicant Signature
Date VCFS0073/11-14