Name Date * Number of Applicants OneTwoThreeFour Person One Name * Place and Hours of Employment * Relationship to Applicant(s) * Date of Birth * Over age 21? Yes Address * Home Phone: Work Phone: Cell Phone: Email address How many others live in home? Are you currently, or have you ever been licensed or applied to be licensed as a foster care provider? * Yes No If yes, with whom: Start Date End Date: Minnesota Rules require that foster parents have, “at least the equivalent of two years of full-time experience caring for or working with the issues presented by the children they will care for”. Please describe your experience, skills and/or education related to foster parenting. Family Alternatives values working cooperatively with the families of our children/youth in foster care when possible. What are your feelings about this expectation? Please describe how you are prepared to actively support a child’s developing identity, sense of belonging or membership in a cultural group. This would include race, ethnicity, culture, faith/spirituality, sexual orientation, gender identity, socio-economic factors and traditions or practices.