For your convenience, simply fill out the form below to request a foster care brochure or to have a foster care representative contact you. When you have filled out all of the fields, press "submit" and your information will be emailed to the Waukesha County Foster Care Program. Thank you.

Today's Date:

Wife's Name:

Wife's DOB:

Husband's Name:

Husband's DOB:

Address:

Daytime Phone Number:

Home Phone Number:

Best Times To Call:

Interested In Child? (yes or no):

Interested In Adult? (yes or no):

Age Group Preference:

Do You Have Children Of Your Own:

Ages Of Your Children:

Would You Like Brochure Mailed To You? (yes or no):

Would You Like A Phone Call? (yes or no):

Waukesha County Foster Home Licensing
500 Riverview Ave.
Waukesha, WI 53188
(262) 548-7675