Perpetual Fostering is a Bolton based fostering agency specialising to provide children and young people with high quality foster care in a safe, secure and nurturing environment.
Perpetual Fostering is a Bolton based fostering agency specialising to provide children and young people with high quality foster care in a safe, secure and nurturing environment.
  Expression Of Interest Form
 

 

Please complete all the following fields before submitting the form to us.
   
Stage 1 | Applicant Details
       
  Title  
  Forename  
  Surname  
  Ethnicity  
  Date Of Birth  

       
Stage 2 | Partner's Details
       
  Title  
  Forename  
  Surname  
  Ethnicity  
  Date Of Birth  

       
  How long in current relationship?   Since:
 
OR
  
OR
  How long married for?   Since:
 
  Stage 3 | Contact Details
       
 

Address Information
Do you live in the UK?

 

Yes

No
     
House Name
House Number
Flat No.
Street
Area
Town/City
Post Code
   
  How long have you lived at your current address?   Months: Years:
 

 
  Home Phone Number  
  Mobile Phone  
  Email  
  Preferred time to contact you?  
 

 

    
  Have you ever lived overseas?  

Yes

No
 

If yes please detail country of residence?

  
  Dates of residence in a country other than the UK?  

From: Month: Year:

To: Month: Year:

  Do you have any young or adult children living at home?  

Yes

No
  If yes please give details  
 

Any children living elsewhere?

  

Yes

No
If yes then please give further details
 

Do you have any pets?

  

Yes

No
 

If yes please give details

  
  What do you like to do together as a family? (Activities, hobbies, clubs, etc)  
 

What type of house do you live in?

  
 

Is this property owned or rented?

  
 

How many bedrooms do you have in your home?

  
 

Do you have a spare bedroom?

  

Yes

No
  If a foster child was living with you would your own children have to share a bedroom?  

Yes

No
       
 

Children/young people requiring foster placements with Independent fostering agencies tend to be aged 10yrs plus

    
 

Please indicate you are aware of this?

  

Yes

No
 

Any concerns?

  

Yes

No
  If yes, please give details  
   
Stage 4 | Health
 
       
 

Are you currently taking any medication?

  

Yes

No
  If yes please give detail and what it is for?  
 

Has anyone in your household been treated for or suffered any significant mental health or depression problems?

  

Yes

No


 

If yes please give details

  
 

Have you ever had an operation or any serious illnesses?

  

Yes

No
  If yes, please give further details  
 

Do you smoke?

  

Yes

No
 

Does anybody else in your household smoke?

  

Yes

No
 

If yes, please give details

 
Are you and your partner currently employed?

Yes

No
 

If yes please provide further details

  
 

If you are the main carer would you be prepared to give up work and if so would you be able to manage financially if you didn’t have a child in placement with yourself as there could be periods when there are gaps in between the placements?

  

Yes

No
 

Have you currently or have you ever worked with children or young people?

  

Yes

No
 

If yes please give details

  
 

Have you or anyone else in your household had any involvement with social services in relation to yours or anyone else’s children?

  

Yes

No
 

Do you or anyone in your household have any criminal convictions, (including spent) any pending or any allegations made against you?

  

Yes

No
  If yes give details.  
 

Does the main applicant own a car, drive, have a full clean UK drivers licence and access to a vehicle at all times?

  

Yes

No
 

Would you be willing to attend training provided by our agency.
(minimum of 6 sets in first year)

  

Yes

No
       
 

How did you find out about Perpetual Fostering?

  
  If Other please give details.  
       
 

Please give details as to why you wish to become a foster carer.

  
   
 

Perpetual Fostering
31 Chorley New Road,
Bolton,
Lancashire
BL1 4QR.

Telephone: 0845 1304748

Email: admin@perpetualfostering.co.uk
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