Foster Family Residence Application Foster Family Residence Application Step 1 of 7 - Your Information 0% Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Phone*Preferred communication*EmailPhone CallTextAre you currently single or married?*SingleMarriedHow long have you been married?*Please enter a number greater than or equal to 0.What is your current housing situation?*RentOwnWhat is your eduction and/or vocational background?*Has your spouse ever been convicted of a felony?*YesNoNames, ages, DOB, and status of each child currently living in your home.*NameAgeDOBStatus Statuses could be biological, adopted, or foster care Spouse InformationName* First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Phone*Preferred communication*EmailPhone CallTextWhat is your eduction and/or vocational background?*Has your spouse ever been convicted of a felony?*YesNo FostercarePeppers Ranch is not a foster care agency. We ask that all families living at Peppers Ranch foster directly through the Department of Human Services. Are you ok with fostering directly through the Department of Human Services?*YesNoHow long have you currently been an open foster home?*2 years3 years4 years5 yearsMore than 5 yearsHow many children have you fostered to date?*1-1011-2021-3031-4041-50Over 50How did you find out about Peppers Ranch foster care community?*What makes you want to live at Peppers Ranch foster care community?*What makes you want to foster?*What age ranges do you currently foster?*Do you have a preference in fostering boys or girls?*Only BoysOnly GirlsBothPeppers Ranch prides itself on its ability to take in sibling groups which are hard to come by within the DHS system. Are you willing to take in sibling sets of 2 or more?*YesNoDescribe your parenting style and techniques of discipline.*Have you gone through any specific parenting trainings to assist with being trauma informed when dealing with foster children?*YesNoMaybeIf yes, that you have gone through specific parenting and/or trauma informed trainings what were these trainings? Was it a specific curriculum?*What has been your most challenging foster care situation that you have had to deal with to date? This might be with a case or with the system - either are appropriate. Do not submit confidential information here.* Life StylesWhat are some of your family hobbies or activities you enjoy participating in?*Pets: furry friends are a part of the family, too! Please provide a list of the animals in your home.*What church do you attend, and how long have you and your family been attending?*Describe your involvement within your church.*Have you previously volunteered for Peppers Ranch?*YesNoDoes your family currently volunteer? If so, where, how often and in what way?*Do you currently donate regularly to entities making a difference in the lives of others?*YesNoSometimes but not regularly Fostering at Peppers RanchIf adequate space and resources were not an issue, how many children would you want to care for in your home?*Describe your commitment to the foster children who have lived with you, are living with you now, or will one day call your house their "home."*Describe your philosophy in reunification of foster children with their biological family.*If you could create the perfect community for foster children, what would that look like?*How do you think you help the foster children in your care?*If approved - what is the first available date you would be available to move to the Peppers Ranch Community.* References*NamePhoneEmailOrganization & TitleWhat is your relationship? Please include at least 4 referencesApplicant Resume*Spouse Resume*Applicant Credit Report*Spouse Credit Report*Any additional information you would like to supply would be welcomed. Thank you for your interest in being a part of the Peppers Ranch family.* Media and Liability ReleaseRELEASE OF LIABILITY*On behalf of myself and each member of my family and any other person who may come onto referenced property as my guest or invitee, I do hereby RELEASE FROM ALL LIABILITY, claims, demands, actions or causes of action, or litigation and further agree to defend, indemnify and hold harmless Peppers Ranch Inc and Peppers Ranch LLC (Owner) and his agents and employees from any costs, damages or liabilities in any way related to any event, circumstance or activity occurring at or related to Owner regardless of whether any of the foregoing occurred as a result of any negligence of misconducts of any of the foregoing persons. Owner reserves the right to revoke the rights granted herein at any time if Owner determines said property is not being used in a safe manner or for any other reason determined by Owner.I agree to liability waiver as mentioned aboveI disagreeMedia Release*I hereby grant Peppers Ranch its legal representatives, agents, successors or assigns, permission to use me or my likeness in photographs, movie films, videotapes and/or sound records, or any part thereof in any and all of its publications, including website entries, without payment or any other consideration. I understand and agree that these materials will become the property of Peppers Ranch and will not be returned. I hereby irrevocably authorize the Peppers Ranch to edit, alter, copy, exhibit, publish or distribute the photographs, movie films, videotapes and/or sound records, for purposes of publicizing the Peppers Ranch programs or for any other lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph. I hereby hold harmless and release and forever discharge the Peppers Ranch legal representatives, agents, successors or assigns, from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization. I am 18 years of age and am competent to contract in my own name. I have read this release before agreeing below and I fully understand the contents, meaning, and impact of this release.I agree to media waiver as mentioned aboveI disagree This iframe contains the logic required to handle Ajax powered Gravity Forms.