FosterParentCollege.com®: Affiliate Application

Affiliate Application Form

Please fill out all fields on this application:

Agency Name (to be listed):

Name (for public contact):

Title:

Mailing Address:

City:

State:

Zip:

Phone:

Fax:

Email:

Website Address:

Counties you provide your services in (please attach if needed):

Additional Branch Locations:

Total number of annual certified training hours required by your agency

Number of hours allowed by your agency through online training.

Monthly Newsletters

E-newsletters should be emailed the following address(es) (for more than 3 please attach):

Name:

Email:

Name:

Email:

Name:

Email:

Weblinks

If you would like to provide a link to FosterParentCollege.com from your site:

Webmaster Name:

Webmaster Phone:

Webmaster Email:

My agency agrees to accept FosterParentCollege.com® training
towards the annual training requirements for our clients.

Signature:

Title:

Printed Name:

Date:

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