2024 Membership Application

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Complete this form and pay your dues via electronic payment. Visit www.pascofapa.com and click on the blue "become a member box". Your application is not complete until this form is completed and payment is made.

Email *

Applicant's LAST Name: *

Applicant's FIRST Name: *

Applicant's Address (Include City and Zip Code): *

Applicant's Phone Number: *

Do you give us permission to text this number? *

Yes

Which of the following applies to your family (Select as many as needed): *

I am a current licensed foster parent

I am an adoptive parent

I am a relative caregiver

I am a non-relative caregiver

Required

Which type of membership are you applying for: *

1. General Member - Any person who is a current Foster, Adoptive, Relative Care, Kinship Care and Non Relative Caregiver/Parent, provided that a current application is on file and all membership dues and fees have been paid in full. General Members shall have a vote on all matters brought to the members of the Association, and each shall receive all information and mailings about state/national activities of the Association.

2. Affiliate Member - Any person or organization ineligible for General membership, but is an Advocate, which includes previously licensed foster parents in good standing, an employee of any agency or organization (governmental or non-governmental) that oversees, regulates, or is otherwise involved in the ongoing care or supervision of Foster or Adoptive children, provided that a current approved application is on file and all membership dues and fees have been paid in full. The benefits of this membership include attending meetings, and receiving mailings and announcements. This membership has no voting rights. Affiliate members are ineligible to participate in special programs. *** If you are in the process of becoming a foster parent, but you are not yet licensed, this would be your level of membership until you have officially become licensed.

3. Honorary Membership - This membership is a lifelong dues waived General membership. This category of members is reserved for former PCFAPA Presidents who completed a full-term (2 years). Past PCFAPA Presidents have one General member vote and a board vote for those whom are active and present at board meetings.

Check the boxes that you have read and understand the following: *

No children under 18 yrs old are permitted to be in the training meetings unless it is clearly noted in the meeting notice

Apple/Angel Special Program(s): The Apple/Angel Special Program(s) are for all LEGAL DEPENDANTS of parents who are current paid general and honorary members in good standing of the Association with children under the age of 18 whom they have legal custody of. **Fosters in official extended foster care are permitted to go beyond this age restriction if they are still in High School. For The Apple Program, members must have completed 2 hours of volunteer work AND attend at least 3 meetings by June 30th. For The Angel Program, members must have completed 5 hours of volunteer work AND attend at least 5 meetings by October 1st.

Failure to abide by the rules of the Pasco County FAPA may result in the revocation of your membership. **Dues are $40 for the year and are due on January 1st of each year.

Previous members are defined as "anyone who has been a member in the previous two years"

A $10.00 late fee will be assessed for renewing members, if the dues are not received by January 31st. **Yearly membership starts 1/1 and expires 12/31 of each year

Member's dependants are defined as those minors under the age of 18, whom the paid member's have legal custody of (biological or adopted), are a licensed foster parent to or whom they have gone through a court system to gain legal custody of (non-relative or relative caregiver)

Required

Household Composition: Currently I/We have ___ Biological Children, ___ Adopted Children, ___ Foster Children, ___ Relative Guardianship, and ___ Non-Relative Guardianship children under the age of 18 living in my/our home. (insert numbers above) Example: 0 Bio, 7 Adopted, 1 Foster, 0 Guardians *

FOSTER PARENTS: (Skip this section if you are not currently a licensed Foster Home) What CBC/Agency are you currently licensed through and who is your licensing specialist?:

ADOPTIVE PARENTS: (Skip this section if you are not an adoptive parent) Where did you adopt from:

Domestically (Privately within the USA)

Domestically (Adoption from Foster Care within the USA)

Internationally

Clear selection

GUARDIANS: (Skip this section if you are not currently a Guardian) How did you legally obtain custody of your current dependents? ** Proof of Guardianship may be requested for either Adoptive or Guardianship Placements.**

Local DCF/DBD dependency court

ICPC from another state

Other:

Clear selection

A copy of your responses will be emailed to the address you provided.

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