___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ Recommendation _____________________________________________________________________________________________ What type of foster child would best benefit from this family/person? (baby, child, male, female, etc.) ______________________________________________________________________________________________________________ Details of foster child(ren) already placed with foster parents Name Sex Date of placement Age at date of placement Date of termination Why terminated Details of parents and siblings of foster children (if known) Name of foster child Names of parents Names of brothers/sisters of foster child Sex Age Religion Address Name of supervising officer ________________________________________________________________________________________ Signature _______________________________________________________________________________________________________ Address ________________________________________________________________________________________________________ Date _______________________________________________________________________________________________________ _____