Foster Grandparent Request for Information

General Information

First Name *

Last Name *

Address *

Apartment #

City *

State *

Zip *

Phone *

Email *

Date of Birth *

mm/dd/yyyy

Marital Status *

Single

Married

Divorced

Widow(er)

Additional Information

Please explain why you wish to be a Foster Grandparent Program Volunteer *

Please describe any experience you have with children, tutoring or mentoring

What languages can you speak and/or translate?

Have you ever served in the military?

Yes

Which branch did you serve in?

Please Read Carefully

Placement in the Foster Grandparent Program is contingent on the outcome of the Online Sex Offender Search, the Criminal Background Check, the PA Child Abuse Background Check and the FBI Fingerprinting Check. Applicants have the right to challenge the outcome of their background checks if they feel they are inaccurate.

If an applicant meets all of the requirements for the program and continues on with training, a physical and TB test will be required. All FGP physicals are done by Concentra Urgent Care at no cost to the applicant.