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

Name (Guardian A)(Required)

Name (Guardian B)(Required)

Email (Guardian A)(Required)

Email (Guardian B)(Required)

Phone (Guardian A)(Required)

Phone (Guardian B)(Required)

Occupation (Guardian A)(Required)

Occupation (Guardian B)(Required)

Date of Birth (Guardian A)(Required)

Date of Birth (Guardian B)(Required)

Adress(Required)

Date of Marriage or Common Law(Required)

Child A (Name and Age)(Required)

Child B (Name and Age)(Required)

Child C (Name and Age)(Required)

Child D (Name and Age)(Required)

Other Adults in Your Home (Name & Ages)

Previous Fostering Experience(Required)

Previous Involvement with child Welfare Agency(Required)

Reasons for Your Interest(Required)

Additional Information(Required)

Date of Inquiry(Required)

Area of Service(Required)

Service Area: North

Service Area: South