Please print form and return to IFAPA, PO Box 729, Mundelein, IL 60060.

Checks for $25 payable to Illinois Foster/Adoptive Parent Association.

Please let us know how many children are in your home. IFAPA is applying for grants and this information helps.

Foster □    Adoptive □    Biological □    Guardianship □    Kinship □    

Name: ________________________________________________________________________

Address: ______________________________________________________________________

City: ___________________________________ State: __________  Zip Code: _____________  

County: ________________________________ E-mail: ________________________________

Phone: (       ) ______ - _______    Fax (       ) _______- _______    Cell (       ) ______-________

The year you became a Foster Parent _________ Your Agency____________________________

Are you a member of a charter group?   Yes □     No □   

If yes, name of charter: _________________________________________________

If no, would you like to know of one in your area.   Yes □     No □    

IFAPA has a lot of projects in the coming year and we need your help. Would you like to help on an IFAPA project or committee.   Yes □     No □