Dear Applicant:

Thank you for your interest in fostering with Knowles Centre Treatment Foster Care Program. The program is currently seeking potential foster parents who are interested in providing care to adolescents with exceptionally high needs (i.e. teenagers who might run away, be experimenting with drugs and alcohol, have difficulties maintaining school placements, etc.).

In addition, we are seeking individuals/families who are wanting to foster one to two youth in a treatment program; are committed to having one adult in their family foster full time; and offer skills and experience related to fostering. This may include fostering with a child and family service agency in the past experience as an educational assistant, youth care, group home, support, or respite worker, etc.

We encourage anyone interested in a career fostering with Knowles Centre to review information on our website about our Treatment Foster Care Program, including the section on frequently asked questions.

As a first step in the process please complete the attached form. We ask that the primary care provider complete the questionnaire in order to assess your family’s skills and abilities and suitability for fostering in a treatment program. Once you have completed this form please mail, e-mail, fax, or drop off your form to:

Program Coordinator

Treatment Foster Care Program

Knowles Centre Inc.

2065 Henderson Highway

Winnipeg, MB R2G 1P7

Fax: (204) 338-9082

E-mail:

Please note that if your application proceeds you will be required to complete a number of background checks including a Prior Contact check, Child Abuse Registry check, Criminal Record check for the vulnerable sector, as well as a Driver’s Abstract. Please do not obtain these checks before being contacted by Knowles Centre.

Thank you again for your interest in providing foster care services with Knowles Centre. All suitable applicantswill be contacted to proceed with the next step in the application process.

Sincerely,

Treatment Foster Care Program

Knowles Centre Inc.

Initial Application to Provide Treatment Foster Parent Services

Please complete the following application and forward to:

Program Coordinator

Treatment Foster Care Program

Knowles Centre Inc.

2065 Henderson Highway

Winnipeg, MB R2G 1P7

Fax: (204) 338-9082

E-mail:

Name(s):.
Current address:
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Home phone:
. / Cell phone:
. / Work phone:
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Email address:
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What is the best way to contact you?
☐ Home phone / ☐ Cell phone / ☐ Work phone / ☐ Email
  1. Are you interested in fostering teenagers (13-18 years old)?

☐No☐Yes

  1. What age group of children would you prefer to have in your home? .
  1. Would you like to foster males, females or either gender?

☐Males☐Females☐Either

  1. Do you currently provide respite or foster care services, or is your home a registered place of safety for any programs or agencies?

☐No

☐Yes (please provide details):

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Are children in care currently in your home?☐No☐Yes

  1. Please list the skills and experience you have related to fostering. This may include fostering with a child and family service agency in the past experience as an educational assistant, youth care, group home, support, or respite worker, etc.Please attach a résumé if applicable.

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  1. Please describe your family in detail in written paragraph form (i.e. who is in your family including names, ages and genders, what your family likes to do in their spare time, what a day in your home looks like and what children would best fit into your home if you were fostering).Please attach additional pages if required.

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  1. In the box below, please draw a floor plan of each level of your home.Mark what each room is used for and where every household member sleeps.

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