Register your Interest with Diverse Care

If you need help completing this form or if you need advice on any aspect of fostering, please don't hesitate to contact us.

 

 

    1. Contact Details

     

    Please enter your contact details here.

     

  1. Title
    Invalid Input
  2. First Name
    Please let us know your first name.
  3. Surname
    Please let us know your surname.
  4. Address 1
    Please let us know the first line of your address.
  5. Address 2
    Invalid Input
  6. Town
    Please let us know the town where you live.
  7. County
    Please let us know your Postcode.
  8. Postcode
    Invalid Input
  9. Country
    Please tell us which country you are from.
  10. Home Telephone
    You must enter one valid telephone number here; if you don't have a landline number please enter your mobile number in this field.
  11. Mobile
    Invalid Input
  12. Email
    Please let us know your email address so we can get in touch.

    13. 2. Additional Information

     

    Please enter some additional information that helps us to process your enquiry.

     

  13. Where did you first hear about Diverse Care?
    Invalid Input
  14. Are you over 21yrs of age?
    We need to know if you are above 21yrs of age.
    You must be over the age of 21 to foster; however, we would like you to continue with the application so that we we may contact you once you reach 21.
  15. Rooms available
    We need to know how many rooms you have to spare.
    You must have at least one spare bedroom in order to foster. If that is not the case, we would like you to continue your application though, as we realise your circumstance might change.
  16. Are you currently a foster carer?
    Please let us know if you currently foster.
  17. Do you have experience of child care?
    Please let us know if you have experience with child care.
    This could be child minding etc.
  18. Would you like us to call you?
    Please tell us when you like to be contacted.
  19. Would you like an information pack?
    Invalid Input
  20. By ticking this box you agree to our terms and conditions. of this website and confirm that you have read and understood our privacy statement.To send the form you need to agree to our terms and conditions.