Child Application - Make-A-Change Inc.

Make-A-Change Program Application Process

20368785_449879992065173_8416751413011462972_o

20431604_1975419389356817_3289183955648388558_n

20429972_1973345106230912_1752578093515665649_n

19420896_1956133001285456_5213295222633033657_n

20708336_1978935459005210_8250614015869132653_n

Do you want your foster, adoptive, or guardian child/children to be apart of the hundreds and thousands of kids that we are impacting? Simply submit an application below to give us more information about your situation and foster child/children! Don’t worry! Keep your children’s personal information private and anonymous. Any information we receive will be private in house for qualification purposes only!

Application Form

Parent Name 1*
First Last
Parent Name 2
First Last
Phone*
Email*
Enter Email Confirm Email
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
How many foster, adoptive, or guardianship children do you have?*
Please put first name and age of foster children below*
Total Family Members*
Do you have reliable transportation?*
- Yes
- No
Check all that apply.
List the top 3 interests each child has like Baseball, Plays, Amusement Parks, Plays, Theater, Music, Football...but be specific please. I.E. Six Flags, Red Sox Fan, Shows, etc.*
Before submitting application, also provide what children's specific needs are.
Social Worker or Counselor Name*
First Last
For foster, adoptive, or guardianship verification.
Social Worker or Counselor Contact Information. Phone number and/or Email.*
Current Employer's of Parents*
Household Income (excluding foster payments)*
Some donors require income qualifications, if so, we will require pay stubs from employer. You will be notified if this is the case for specific experiences. We will do our best to always provide a life changing experience and education to every foster child one way or another.
CAPTCHA