On Your Feet Northern California Application
Thank you for your interest in On Your Feet. Please complete the following form to join our network and learn more about OYFF services and upcoming events. OYFF does not discriminate on the basis of race, color, religion (creed), gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status. OYFF will not share your information. OYFF is not affiliated with any adoption agency or attorney.
First Name
Your answer
Last Name
Your answer
Email Address *
Your answer
How did you learn about OYFF?
Mailing Address
Street
Your answer
City
Your answer
*
State
Your answer
*
Zip
Your answer
Most of our communication is via email. Do you wish to also receive occasional "snail mail"?
Phone Number
Please include the area code
Your answer
What state(s) did you live in at the time(s) of placement?
Your answer
What state(s) does your child(ren) live in?
Your answer
What is your current employment status?
Please indicate your approximate annual income:
Do you have health insurance?
If you do have health insurance, what type?
Your answer
Please indicate the number of dependents you have:
Do you consider yourself to be:
Please indicate your marital status:
Please indicate the category you most identify with:
What is your date of birth? *
MM
/
DD
/
YYYY
What is the highest level of education completed?
What is the birth date(s) of the child(ren) you placed? *
MM
/
DD
/
YYYY
MM
/
DD
/
YYYY
MM
/
DD
/
YYYY
Please list the agency and/or attorney that assisted you in your placement:
Your answer
Would you like our Program Director to contact you and answer any questions?
If yes, please list the best number to reach out and some good days and times.
Your answer
Please check your interests:
Submit
Never submit passwords through Google Forms.
This form was created inside of On Your Feet Foundation. Report Abuse - Terms of Service - Additional Terms