Online Inquiry
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Click the 'Generate Form' link to pre-populate the form when you are ready.
<ul class="er_fld_row"><li class="er_fld_type_text" draggable="false" style="width: 50%;" map_to="FH_Name_First_A"> <i class="fa fa-font"></i><label class="er_fld_label required">First name</label><input name="CST_1" type="text" class="er_fld_required er_fld_width50"></li></ul><ul class="er_fld_row"><li class="er_fld_type_text" draggable="false" style="width: 50%;" map_to="FH_Name_Last_A"> <i class="fa fa-font"></i><label class="er_fld_label required">Last name</label><input name="CST_2" type="text" class="er_fld_required er_fld_width50"></li></ul><ul class="er_fld_row"><li class="er_fld_type_text" draggable="false" style="width: 50%;" map_to="FH_EMail"> <i class="fa fa-font"></i><label class="er_fld_label required">Email</label><input name="CST_5" type="text" class="er_fld_required er_fld_width50"></li></ul><ul class="er_fld_row"><li class="er_fld_type_text" draggable="false" style="width: 100%;" map_to="FH_Phone_Mobile"> <i class="fa fa-font"></i><label class="er_fld_label required">Phone number</label><input name="CST_6" type="text" class="er_fld_required er_fld_width50"></li></ul><ul class="er_fld_row"><li class="er_fld_type_content" draggable="false"> <i class="fa fa-info-circle"></i><label>Guidelines\Help Text</label><div class="cst_content er_fld_fontstyle_bold">Home Address</div></li></ul><ul class="er_fld_row"><li class="er_fld_type_text" draggable="false" map_to="FH_Address_Street_1" style="width: 50%;"> <i class="fa fa-font"></i><label class="er_fld_label required">Street Address</label><input name="CST_10" type="text" class="er_fld_required er_fld_width50"></li></ul><ul class="er_fld_row"><li class="er_fld_type_text" draggable="false" map_to="FH_Address_City" style="width: 50%;"> <i class="fa fa-font"></i><label class="er_fld_label required">City</label><input name="CST_12" type="text" class="er_fld_required er_fld_width25"></li></ul><ul class="er_fld_row"><li class="er_fld_type_text" draggable="false" map_to="FH_Address_Zip" style="width: 50%;"> <i class="fa fa-font"></i><label class="er_fld_label required">Zip code</label><input name="CST_15" type="text" class="er_fld_width25 er_fld_required"></li></ul><ul class="er_fld_row"><li class="er_fld_type_number" draggable="false" map_to="FH_NumBedrooms" style="width: 50%;"> <i class="fa fa-hashtag"></i><label class="er_fld_label required">Number of bedrooms</label><input name="CST_26" type="text" class="er_fld_required er_fld_width25"></li></ul><ul class="er_fld_row"><li class="er_fld_type_dropdown" draggable="false" map_to="FH_ReferralSource" style="width: 100%;"><i class="fa fa-caret-down"></i><label class="er_fld_label required">How did you hear about us?</label><select name="CST_16" class="er_fld_required er_fld_width25"><option value="Billboard">Billboard</option><option value="Church/Pastor">Church/Pastor</option><option value="Community Events">Community Events</option><option value="County Referral ">County Referral </option><option value="Display Table at Event">Display Table at Event</option><option value="Employee">Employee</option><option value="Foster Parent">Foster Parent</option><option value="Google">Google</option><option value="Other">Other</option><option value="Other Agency">Other Agency</option><option value="Other Agency Foster Parent">Other Agency Foster Parent</option><option value="Protective Services">Protective Services</option><option value="Radio/TV Ad">Radio/TV Ad</option><option value="Social Media">Social Media</option><option value="Website">Website</option></select></li></ul><ul class="er_fld_row"><li class="er_fld_type_checkbox" style="white-space: normal; width: 50%;" draggable="false" map_to="FH_Interest"><i class="fa fa-check-square-o"></i><label class="er_fld_label required">Interested in:</label> <label class="er_option"><input class="type_checkbox" type="checkbox" name="CST_18" value="Foster Care">Foster Care</label><label class="er_option"><input class="type_checkbox" type="checkbox" name="CST_18" value="Intensive Foster Care">Intensive Foster Care</label><label class="er_option"><input class="type_checkbox" type="checkbox" name="CST_18" value="Concurrent Planning (foster-to-adopt)">Concurrent Planning (foster-to-adopt)</label><label class="er_option er_option_other er_option_other_off"><input class="type_checkbox er_option_other er_fld_required" type="checkbox" name="CST_18" value="Other:">Other:<input class="cst_Other er_fld_required" name="CST_18_Other" type="text"></label></li></ul><ul class="er_fld_row"><li class="er_fld_type_text" draggable="false" style="width: 100%;"> <i class="fa fa-font"></i><label class="er_fld_label required">What age range are you interested in fostering?</label><input name="CST_24" type="text" class="er_fld_width25 er_fld_required"></li></ul><ul class="er_fld_row"><li class="er_fld_type_paragraph er_fld_type_paragraph_small" draggable="false" map_to="FH_Inquiry_Why_Parents" style="width: 50%;"> <i class="fa fa-paragraph"></i><label class="er_fld_label required">Why do you want to be a foster/adoptive parent?</label><textarea name="CST_19" style="width:100%;" class="er_fld_required er_fld_width50"></textarea></li></ul><ul class="er_fld_row"><li class="er_fld_type_paragraph er_fld_type_paragraph_small" draggable="false" map_to="FH_Inquiry_Comments" style="width: 50%;"> <i class="fa fa-paragraph"></i><label class="er_fld_label required">Do you have any questions or comments?</label><textarea name="CST_20" style="width:100%;" class="er_fld_required er_fld_width50"></textarea></li></ul><ul class="er_fld_row"><li class="er_fld_type_checkbox" style="white-space:normal;" draggable="false"><i class="fa fa-check-square-o"></i><label class="er_fld_label required">Upcoming Trainings </label> <label class="er_option"><input class="type_checkbox" type="checkbox" name="CST_27" value="Thursday, Oct 17 from 9:00AM - 10:30AM">Thursday, Oct 17 from 9:00AM - 10:30AM</label><label class="er_option"><input class="type_checkbox" type="checkbox" name="CST_27" value="Tuesday, Nov 12 from 11:00AM - 12:30PM">Tuesday, Nov 12 from 11:00AM - 12:30PM</label><label class="er_option"><input class="type_checkbox" type="checkbox" name="CST_27" value="Monday, Dec 9 from 11:00AM - 12:30PM">Monday, Dec 9 from 11:00AM - 12:30PM</label><label class="er_option er_option_other er_option_other_off"><input class="type_checkbox er_option_other er_fld_required" type="checkbox" name="CST_27" value="Other:">Other:<input class="cst_Other er_fld_required" name="CST_27_Other" type="text"></label></li></ul><ul id="er_row_last" class="er_fld_row"><li class="er_fld_type_text er_fld_selected" draggable="false"> <i class="fa fa-font"></i><label class="er_fld_label">Zoom Link for Zoom Trainings All Dates - Please Copy Link</label><input name="CST_31" type="text" value="https://us06web.zoom.us/j/84048298999?pwd=bmFaYx2xLVuXRi0IFpd2xs90ya086k.1"></li></ul>
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