Foster Family Referral Bonus

PCHAS Foster Family Referral Form

Please fill out and submit the following form if you have referred a prospective foster family to PCHAS. This will ensure that you will be paid the referral bonus according to the following terms.

Bonus:

$300 for new foster family who has a child/children for a minimum period of 30 days.

Date

First Name*

Last Name*

Your Email*

Phone*

City*

Name of family you referred to PCHAS*

Additional Info

May we send foster care info via email to family?

YesNo

* denotes required fields