West Valley Child Crisis Center

Becoming a foster or adoptive parent is one of the most meaningful, beautiful things you can do in your life. The most important requirement for becoming a parent is to love your child.

Some of the other requirements for becoming a foster parent are:

21 Years old (18 for adoption)
Medical Exam
Finger printed
First Aid / CPR
Single, married, in a partnership, or widowed
Own or rent your home (just need room for children)
Any ethnicity or religious background welcome
Complete 30 hours of training
U.S. legal status

If you are interested in learning more about becoming a foster or adoptive parent, please complete the Interest form below and we will contact you. If your prefer to complete the form on paper, you may download a PDF here and fax or mail it in to the WVCCC office.

Full Name *

Home Address *

Address

Address 2

City State Zip

Phone # *

Email Address

Type of Service *

Orientation

Orientation Date

Motivation

Family Member Name(include self)	Relationship To Applicant	Marital Status	General Health/Mental issues? Are you taking any meds?	How long have you been in AZ?

If any criminal history, please explain (Please include any CPS History):

Have you or your spouse been previously married? *

Yes No If yes, how many times?

Would you be able to provide us with proof of legal separation or divorce decree per marriage?

Who in your household is currently employed?	Name of Employer	Hours per week

Have you ever filed bankruptcy? *

Yes No IF YES, Please list DISCHARGE DATE:

Have you ever been court ordered to provide child support? *

Yes No IF YES, Please provide Atlas’ #

Have you ever had any involvement with any other foster care/adoption agency? *

Yes No

If yes, please list names, dates and training received

How did you hear about West Valley Child Crisis Center?