Type of Position
          Fulltime Foster Parent

Part time Respite Provider



TFC Inquiry Form

Identify "Primary Applicant" as the person who will spend the most time with a child in care.

      Primary Applicant:       Co-Applicant:

 Street Address:   City:  State:  ZIP:     


 Select region                                                                                                        Home Phone:  
 Work Phone:   Work Phone:               Cell Phone:
 Cell Phone:                                                        E-Mail:
 Is each Applicant at least twenty-five years of age?   Yes  No                                  What is the best time to call you?  
 Years Married (If Applicable):                   Number of years a resident of the State of New Mexico

List the Names, Age and Gender of  your Children Living at Home



List All of your Children Who are Living Away from Home; Include their Age and Gender



Including Applicants, how many people ages 18 and above live in your home?
 Have you ever been a foster parent before?Yes No        
  For what Agency?                  Name of Social Worker:  
 Have you ever applied to HDFS or to any other agency to become a foster parent/Treatment Foster Care Parent or an adoptive parent? Yes No
Please List  Agency(ies)          
Do you understand that HDFS will do a criminal background check on each adult in the home? Yes No
Please describe in detail why you want to become a treatment foster parent or respite provider.
What qualities do you possess that would make you a good foster parent? Please answer this question completely and thoughtfully.

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Copyright 2006 by High Desert Family Services, LLC. All rights reserved.
Revised: 07/23/17