* 1. Which of the following best describes your current relationship status?

* 2. Do you rent or own the place where you live?

* 3. In what ZIP code is your home located? (enter 5-digit ZIP code; for example, 00544 or 94305)

* 4. In what year were you born? (enter 4-digit birth year; for example, 1976)

* 5. How many children age 17 or younger live in your household?

* 6. How many people currently live in your household?

* 7. How many bedrooms are in your home?

* 8. Which category below includes your age?

* 9. What is keeping you from being a foster parent?

* 10. What would help you feel "at home" if you were displaced from your home?

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