Adoption and Fostering Online Enquiry Form

Please select one or both:
*
Adoption
Fostering

Title * Select Miss Ms Mr Mrs Dr Rev Sir

First Name *

Surname / Family Name *

Date of Birth *
eg: 01/01/1999

Occupation *

Do you work for Birmingham City Council? *
Yes
No

Are you applying with a partner?
*
No
Yes

If yes, please specify name and date of birth:

Property Number / House Name *

Street Name *

Town or City *

Postcode *

Telephone Number *

Alternate Telephone Number

Email address *

When is the best time to contact you?

Were you referred by a Birmingham City Council Foster Carer? *
Yes
No

If yes, please tell us her / his name:

Advertisement * Select No Yes

If 'Yes' please say where:

Poster * Select No Yes

If 'Yes' please give the location:

Another web site * Select No Yes

If 'Yes' please say which one:

Word of Mouth * Select No Yes

If 'yes', please state who told you about us:

Somewhere else * Select No Yes

If 'yes', please state from where