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Petition to Host – Weekend

Kidsave is seeking married and single adults interested in hosting children who are available for adoption in Metropolitan Washington, DC (age 12 and up), or Los Angeles County, CA (age 9 and up). If you are interested in mentoring a child please complete this form.

If you would like to do the occasional weekend activity, but not take on a regular ongoing role as a child host, we invite you to consider becoming a volunteer for Weekend Miracles.

Information on two applicants (if married or living together) is requested because both will require fingerprinting and child abuse clearances.

Name (App. 1):

Age (App. 1):

Occupation (App. 1)

Employer Name (App. 1)

Name (App. 2):

Age (App. 2):

Occupation (App. 2):

Employer Name (App. 2)

Home Address:

City:

State:

Zip:

Marital Status:

   Single         Married

Other children at home and ages:

Contact Information:

Home:

phone:

E-mail:

Office (App. 1):

phone:

E-mail:

Office (App. 2):

phone:

E-mail:

Homestudy Status:

Do you have an approved homestudy?

Yes  No

If no, have you begun your homestudy?

Yes  No

If yes, estimated completion date:

Other desires or comments regarding a child.  If you are interested in becoming an advocate for a child, rather than mentoring a child, please tell us about your interests.

Where, or how, did you learn about Weekend Miracles?
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