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.
How did you learn about OYFF?
family or friend
your child's adoptive family
the agency or attorney who helped with your placement
Most of our communication is via email. Do you wish to also receive occasional "snail mail"?
Please include the area code
What state(s) did you live in at the time(s) of placement?
What state(s) does your child(ren) live in?
What is your current employment status?
Not currently employed
Please indicate your approximate annual income:
Less than $20,000 annually
More than $50,000 annually
Do you have health insurance?
If you do have health insurance, what type?
Please indicate the number of dependents you have:
Do you consider yourself to be:
Heterosexual or straight
Gay or Lesbian
Please indicate your marital status:
Please indicate the category you most identify with:
American Indian or Alaska Native
Black or African American
Native Hawaiian or Other Pacific Islander
What is your date of birth?
What is the highest level of education completed?
Some high school
High School diploma or GED
AA or AS
BA or BS
MA or MS
Ph.D or other advanced degree
What is the birth date(s) of the child(ren) you placed?
Please list the agency and/or attorney that assisted you in your placement:
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.
Please check your interests:
Education/Life Skills Grant
In order for us to better serve you and prepare any referrals, are currently experiencing any of the following?
Suicidal thoughts or severe depression
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