MINISTRY OF SOCIAL AND FAMILY DEVELOPMENT CHILDREN IN CARE SERVICE FOSTERING SERVICES MSF FOSTERING SCHEME: APPLICATION FORM FOR FOSTER PARENTS 1 PERSONAL PARTICULARS (FEMALE APPLICANT) Full name (Block Letters) Telephone no. Home: Office: Hp: Nationality Singaporean Permanent Resident Others, please specify: NRIC/FIN: Date of Birth: Age: Home Address Email Address Ethnic Group Chinese Malay Indian Eurasian Others, please specify Religion Christianity Islam Buddhism Taoism Hinduism Others, please specify: Monthly Income ($): <2,000 2,000 to 4,000 4,000 to 6,000 6,000-8,000 >8,000 Not Applicable Marital Status Single Married Divorced Widowed Others, please specify Highest Educational Level Primary Secondary Post Secondary Diploma Degree Post graduate diploma Masters PhD Others, please specify: Language Mandarin: Spoken / Written Malay: Spoken / Written Tamil: Spoken / Written English: Spoken / Written Others, please specify: Employment status: Unemployed Self employed Employed Retired Occupation: Name of org: 2 PERSONAL PARTICULARS (MALE APPLICANT)
Full name (Block Letters) Telephone no. Home: Office: Hp: Nationality Singaporean Permanent Resident Others, please specify: NRIC/FIN: Date of Birth: Age: Home Address (As indicated above ) Email Address Ethnic Group Chinese Malay Indian Eurasian Others, please specify Religion Christianity Islam Buddhism Taoism Hinduism Others, please specify: Monthly Income ($): <2,000 2,000 to 4,000 4,000 to 6,000 6,000-8,000 >8,000 Not Applicable Marital Status Single Married Divorced Widowed Others, please specify Highest Educational Level Primary Secondary Post Secondary Diploma Degree Post graduate diploma Masters PhD Others, please specify: Language Mandarin: Spoken / Written Malay: Spoken / Written Tamil: Spoken / Written English: Spoken / Written Others, please specify: Employment status: Unemployed Self employed Employed Retired Occupation: Name of org: 3 INFORMATION ON CHILDREN OF APPLICANTS LIVING IN THE SAME HOUSEHOLD Name (as per NRIC/ Birthcert) Sex ID Number Age Name of School / Occupation Any medical conditions? (Pls specify level of care required) F / M F / M F / M 3 INFORMATION ON CHILDREN OF APPLICANTS LIVING IN THE SAME HOUSEHOLD
Name (as per NRIC/ Birthcert) Sex ID Number Age Name of School / Occupation Any medical conditions? (Pls specify level of care required) F / M F / M 4 INFORMATION ON OTHER MEMBERS IN THE HOUSEHOLD (Including tenants and domestic helpers) Name (as per NRIC/ Birthcert) Sex ID Number Age Name of School/ Occupation Relationship to applicants F / M F / M F / M 5 PREFERRED FOSTER CHILD (You may tick more than one box) Age Under 1 year 1 year – 3 years 4 years – 6 years 7 years – 12 years 13 years and above Male Female Are you open to caring for a child with special needs? Yes No Other remarks 6 EXPERIENCE IN CARING FOR CHILDREN Do you have any experience in working with or caring for children? Yes No Please elaborate: 7 HOUSING Housing type: 1 room HDB 3 room HDB 4 room HDB 5 room HDB Executive Condo Private Condo Landed property Others, please specify: Number of bedrooms: Ownership Status: Rented Purchased Others, please specify: Is your home fixed with window grilles for all windows and balconies? Yes No If No, are you prepared to install window grilles for all your windows and balconies? Yes No Kindly note that window grilles are mandatory for foster children aged 1 – 12 years old. 8 HOUSEHOLD INCOME