School Registration Form Children In Care
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3SCHOOL REGISTRATION FORM: Children in Care
(Form available at )
( Please check off
DEMOGRAPHICS
Authority you
represent)
Name: _________________________________________________________________________
Date of Birth: ____________________________________________________________________
MET#: ______________________________
PHIN: ________________________________
Legal Guardian/Agency: ________________
Mailing Address: ______________________
Phone Number: _______________________
Fax Number: __________________________
Child and family services worker: ____________________________________________________
Phone Numbers
Office: _______________________________
Mobile: _______________________________
Fax Number: _________________________
Email: ________________________________
Foster Placement: ________________________________________________________________
Mailing Address: _________________________________________________________________
Phone Number: ______________________
Email: ________________________________
CHILD AND FAMILY SERVICES STATUS
(Check which best applies, provide date(s))
Voluntary Placement Agreement
____________________________ (date)
Voluntary Surrender of Guardianship
____________________________ (date)
Extension of Care
____________________________ (date)
Apprehension
____________________________ (date)
Supervision Order
____________________________ (date)
Temporary Order of Guardianship to
____________________________ (date)
Permanent Order of Guardianship ____________________________ (date)
Expected length of placement (emergency or long-term): ________________________________
Approved for Contact:
Name: _______________________________
Role: _________________________________
Name: _______________________________
Role: _________________________________
Name: ______________________________
Role: _________________________________
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Parent category: Life