Child and Family Services of Central Manitoba

Foster Care Inquiry – Intake Form

If you are interested in becoming a Foster Parent please fill out the below inquiry form and return to our agency using the contact information below and a Foster Care Worker will contact you. PDF Inquiries can be sent to cfscentral@gov.mb.ca

Required fields that do not apply can be filled as ‘none’ or ‘not applicable’ (NA).

Foster Inquiry - PDF

"*" indicates required fields

Applicant's Name*

Partner/Spouse's Name

Applicant's Phone*

Partner/Spouse's Phone

Applicant's Email*

Partner/Spouse's Email

Applicant's Occupation*

Partner/Spouse's Occupation

Applicant's DOB*

Partner/Spouse's DOB

Home Address*

Street Address Address Line 2 City Province Postal Code

Date of Marriage or Common Law*

Child's Name and Age

Other Adults in your home: Names and Ages:

Foster for what age and gender of child(ren):

Availability*

Previous Foster and/or Fostering Experience

Additional Information

Date of Inquiry*

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