Resource Family Application

1. Application information is true and will be treated as confidential.

2. The applicant(s) is not obligated, if called upon, to perform the services herein applied for and that COBYS Family Services is not obligated to assign, or actively seek to assign the applicant a foster/adoptive child.

3. As part of the agency's approval process, additional personal information will be sought from the applicant(s) by COBYS personnel.

4. All prior foster care/adoption agencies will be contacted and asked to provide a reference.

5. By providing phone numbers and email addresses, the applicant(s) agree(s) to being contacted through these methods.

6. The applicant(s) has not been convicted of any offense related to the abuse of children or violent or assaultive behavior.

7. If applicable, the applicant(s) will submit a copy of protection from abuse order(s) after their application has been processed.

8. I, the applicant(s) have received, read, and understand COBYS Family Services Notice of Privacy Practices.