[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-305982-105":53,"doc-detail-305982-en":127},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":120,"head_meta":122,"extra_data":124,"updated_unix":126},105,"en","caregiver-application-form-instructions-and-applicanthousehold-information","CAREGIVER APPLICATION FORM - Instructions and Applicant/Household Information","","Caregiver Application Form for Lii Michif Otipemisiwak Family and Community Services. Includes completion instructions for handwriting submissions, guidance to attach additional pages, and sections to collect information about applicant #1 and applicant #2, including names, aliases, dates of birth, place of birth, ethnic origin, languages, Aboriginal identity, social insurance numbers, and addresses. Also captures household members, child and extended family details, foster or other resource history, marital/relationship details, religion and beliefs, education, training, employment history, income, child care arrangements, interests, health history, and prior foster application questions.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/caregiver-application-form-instructions-and-applicanthousehold-information/305982/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/caregiver-application-form-instructions-and-applicanthousehold-information/305982.png","ImageObject",442,249,{"name":88,"@type":89},"Pentious","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-07","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",10,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"How should the form be completed if filling it out by hand?","Question",{"text":109,"@type":110},"Print clearly using an ink pen. If there is not enough space for responses, place answers on a separate piece of paper and attach it to the application.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"What information is collected for each applicant (Applicant #1 and Applicant #2)?",{"text":114,"@type":110},"The form collects full name, also known as (including maiden name if applicable), date of birth, place of birth, ethnic origin, languages spoken, Aboriginal identity details, and social insurance number, along with education, training, and employment information.",{"name":116,"@type":107,"acceptedAnswer":117},"Which parts of the application cover household, children, and health information?",{"text":118,"@type":110},"Sections include children and extended family member details, other persons in the home, questions about foster/family care or other resources, and a health history section covering members’ health, serious health issues, and mental/emotional health counseling.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},305982,1789831724,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":47,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":126,"read_time":73},1374404730887,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Lii Michif Otipemisiwak Family and Community Services  \n707 Tranquille Road, Kamloops, BC • V2B 3J1  \nTel: (250) 554-9486 Fax: (250) 554-9487  \nCAREGIVER APPLICATION FORM  \nINSTRUCTIONS:  \nIf you are filling out this form by hand, please print clearly using ink pen. If you cannot find enough space to include all of you responses to any of the questions on this form, please place on a separate piece of paper and attach it to this application. Once you have completed this form, return it to your Resource Worker.  \n\n| PART 1 |  |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- |\n| APPLICANT \\#1 |  |  |  |  |  |  |\n| FULL NAME |  | ALSO KNOWN AS (INCLUDING MAIDEN NAME IF APPLICABLE) |  |  | DATE OF BIRTH(YYYY/MM/DD) |  |\n| PLACE OF BIRTH | ETHNIC ORIGIN |  |  | LANGUAGES SPOKEN |  |  |\n| DO YOU CONSIDER YOURSELF ABORIGINAL\u003Cbr>􀂅 YES 􀂅 NO |  |  | IF YES, IDENTIFY YOUR ABORIGINAL CULTURAL GROUP OR FIRST NATION |  |  | SOCIAL INSURANCE NUMBER |\n\n\n| APPLICANT \\#2 |  |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- |\n| FULL NAME | ALSO KNOWN AS (INCLUDING MAIDEN NAME IF APPLICABLE) |  |  | DATE OF BIRTH(YYYY/MM/DD) |  |  |\n| PLACE OF BIRTH |  | ETHNIC ORIGIN |  |  | LANGUAGES SPOKEN |  |\n| DO YOU CONSIDER YOURSELF ABORIGINAL\u003Cbr>􀂅 YES 􀂅 NO |  |  | IF YES, IDENTIFY YOUR ABORIGINAL CULTURAL GROUP OR FIRST NATION |  |  | SOCIAL INSURANCE NUMBER |\n\n\n| ADDRESS |  |  |  |  |\n| --- | --- | --- | --- | --- |\n| HOME ADDRESS |  | CITY/TOWN |  | POSTAL CODE |\n| MAILING ADDRESS (IF DIFFERENT) |  | CITY/TOWN |  | POSTAL CODE |\n| DIRECTION TO HOME IF NEEDED |  |  |  |  |\n| AREA CODE AND HOME PHONE NUMBER | AREA CODE & WORK PHONE (APPLICANT \\#1) |  | AREA CODE & WORK PHONE NUMBER (APPLICANT \\#2) |  |\n\n\n| INFORMATION REGARDING CHILDREN AND EXTENDED FAMILY MEMBERS |  |  |  |  |\n| --- | --- | --- | --- | --- |\n| NAME | GENDER M/F | BIRTHDATE YYYY/MM/DD | RELATIONSHIP | LOCATION |\n|  |  |  |  |  |\n|  |  |  |  |  |\n|  |  |  |  |  |\n|  |  |  |  |  |\n|  |  |  |  |  |\n|  |  |  |  |  |\n|  |  |  |  |  |\n\nHave any of your children ever been placed in foster/family care, treatment or correctional resource?  \n􀂅 YES 􀂅 NO IF YES:   \n\n| FOSTER/FAMILY CARE |  |  |\n| --- | --- | --- |\n| WITH WHOM | WHERE | DATE(S) (YYY/MM/DD) |\n\n\n| OTHER RESOURCE |  |  |\n| --- | --- | --- |\n| NAME OF RESOURCE | WHERE | DATE(S) (YYY/MM/DD) |\n\n\n| OTHER PERSONS IN YOUR HOME (e.g., boarders, daycare children other than own children) |  |  |  |  |\n| --- | --- | --- | --- | --- |\n| NAME | GENDER\u003Cbr>M/F | AGE | RELATIONSHIP | DAY CARE OR RESIDENT |\n|  |  |  |  |  |\n|  |  |  |  |  |\n|  |  |  |  |  |\n\n\n| PART II |  |\n| --- | --- |\n| MARITAL/OTHER RELATIONSHIP |  |\n| LEGAL RELATIONSHIP OF APPLICANT TO EACH OTHER | DATE OF MARRIAGE OR LENGTH OF LEGAL RELATIONSHIP |\n\nRELIGION/SPIRITUAL VALUES/BELIEF SYSTEM  \nDescribe your religion/spiritual values/belief system:  \n\n| APPLICANT \\#1 | APPLICANT \\#2 |\n| --- | --- |\n\n\n| EDUCATION AND EXPERIENCE (including date(s) when completed) |  |\n| --- | --- |\n| APPLICANT \\#1 |  |\n| EDUCATION COMPLETED | SPECIAL TRAINING |\n| FAMILY /CHILD CARE RELATEED COURSES TAKEN |  |\n| SPECIAL EXPERIENCE RELATED TO FAMILY CARE |  |\n\n\n| APPLICANT \\#2 |  |\n| --- | --- |\n| EDUCATION COMPLETED | SPECIAL TRAINING |\n| FAMILY /CHILD CARE RELATEED COURSES TAKEN |  |\n| SPECIAL EXPERIENCE RELATED TO FAMILY CARE |  |\n\n\n| EMPLOYMENT/OCCUPATION |  |\n| --- | --- |\n| APPLICANT \\#1 | APPLICANT \\#2 |\n| PRESENT EMPLOYMENT/OCCUPATION | PRESENT EMPLOYMENT/OCCUPATION |\n\n\n| LENGTH OF PRESENT\u003Cbr>EMPLOYMENT/OCCUPATION | PART TIME/FULL TIME | LENGTH OF PRESENT\u003Cbr>EMPLOYMENT/OCCUPATION | PARTTIME/FULLTIME |\n| --- | --- | --- | --- |\n\nFAMILY’S APPROXIMATE GROSS YEARLY INCOME  \n$  \n\n| CHILD CARE ARRANGEMENTS |\n| --- |\n| IF APPLICANT(S) IS/ARE WORKING, DESCRIBE CHILD CARE ARRANGEMENTS FOR YOUR PRESCHOOL AND SCHOOL AGED CHILDREN |\n|  |\n|  |\n|  |\n\n\n| FAMILY GROUP AND INDIVIDUAL INTERESTS, ACTIVITIES, HOBBIES (Please list) |  |\n| --- | --- |\n| 1. | 5. |\n| 2. | 6. |\n| 3. | 7. |\n| 4. | 8. |\n\n","cbCainPnL8jXz7y3","https://ap.wps.com/l/cbCainPnL8jXz7y3","pdf",278655,"English","# Instructions\n# Applicant Information (Applicant #1)\n# Applicant Information (Applicant #2)\n# Addresses and Contact Information\n# Children and Extended Family Members\n# Other Resources and Other Persons in Home\n# Part II: Marital/Relationship Details\n# Religion/Spiritual Values/Belief System\n# Education and Experience\n# Employment/Occupation and Hours\n# Income\n# Child Care Arrangements\n# Interests, Activities, Hobbies\n# Health History\n# Prior Foster Applications\n# Type of Child Care You Could Provide\n# Special Needs and Type of Placement Desired\n# Home Accommodation","[{\"question\":\"How should the form be completed if filling it out by hand?\",\"answer\":\"Print clearly using an ink pen. If there is not enough space for responses, place answers on a separate piece of paper and attach it to the application.\"},{\"question\":\"What information is collected for each applicant (Applicant #1 and Applicant #2)?\",\"answer\":\"The form collects full name, also known as (including maiden name if applicable), date of birth, place of birth, ethnic origin, languages spoken, Aboriginal identity details, and social insurance number, along with education, training, and employment information.\"},{\"question\":\"Which parts of the application cover household, children, and health information?\",\"answer\":\"Sections include children and extended family member details, other persons in the home, questions about foster/family care or other resources, and a health history section covering members’ health, serious health issues, and mental/emotional health counseling.\"}]","CAREGIVER APPLICATION FORM - Instructions and Applicant/Household Information | PDF"]