2. First Name*
3. Last Name*
5. Email Address*
6. Phone Number*
8. Participant is the same as above

   1. Yes
10. Participant First Name
11. Participant Last Name
13. Check here if you have already registered as a couple for the same date and the first participant completed the below info

    1. Already submitted
15. Address1
17. Address2
19. City
20. State
21. Zip
23. Do you have any language assistance needs, if so please indicate here?
25. Are you interested in providing foster care or adoption through the Collaborative Foster Care Program?

    1. Yes
    2. No, I am with another agency
27. Please discontinue registering. We do not currently offer training to families outside of our program.
29. What is your area of interest?

    1. Foster Care
    2. Adoption of children over the age of 10
    3. Kinship Care
    4. ICPC- Interstate Compact on the Placement of Children
31. Your participation at information night is optional. Please contact the child's caseworker about next steps on beginning the certification process.
33. Your participation at information night is optional. Please contact the ICPC worker in the county in which you reside for more information. Arapahoe- 303.734.4365, Douglas- 303.814.5338, Jefferson- 303.734.4345
35. How did you hear about the Collaborative Foster Care Program (please check all that apply)?

    1. Adoption Exchange
    2. Advertisement/ Flyer
    3. Banner/ Poster
    4. County website
    5. Current/ Former Foster Parent
    6. Department of Human Services Team Member
    7. Event
    8. Faith Based Organization
    9. Friend/ Relative
    10. Internet search
    11. Personal Experience
    12. Phone Book
    13. Print media (newspaper/ magazine)
    14. Professional in the Field
    15. Project 1.27
    16. Radio
    17. State Department Website
    18. Television
    19. Transfer from other agency
    20. Other (please explain)
37. What was the name of the event?
39. What is the name of the Foster Parent who referred you? (We'd like to thank them)
41. What is the name of the Team Member who referred you? (We'd like to thank them)
Leave This Blank:


43. Submit

* indicates a required field