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The county of Worcestershire includes the districts of:

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Worcestershire County Council, County Hall, Spetchley Road, Worcester, WR5 2NP - Directions to Council Offices


I'm interested in?	Adoption Fostering Adoption and Fostering
My Details are:-
Title
First name
Surname
Date of Birth
Ethnicity
My Partner's Details (where applicable) are:
Title
First Name
Surname
Date of Birth
Ethnicity
My status is?	Single Married Civil Partnership In a relationship In a same sex relationship
Do you have birth/adopted children?	Yes No
If yes please provide details/ages:	.
Contact details
Address	.
Postcode
Home phone number
Mobile phone number
Email Address*
Preferred method of contact (click on all that apply)	Postal Home phone Mobile Email
What is the employment status of the main applicant/enquirer?	Employed (part-time) Employed (full-time) Self-Employed Unemployed Retired
Does anyone smoke in the household?	Yes No
How many bedrooms are in your property?
How many spare rooms are in your property?
Do you have any childcare experience?	Yes No
If yes please give details	.
Where did you find our details?
In order to be considerate to the environment we can send our Information Pack by email.
Please indicate whether you would prefer:	Pack by email Pack by post
*If you have requested 'by email' please ensure your email address is provided above.
We understand that you might have specific questions you would like to ask and we are always happy to answer your questions. Please indicate here if you would like someone to contact you before sending you a pack (and ensure we have the right contact details above)	Contact me before sending out the pack.
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