The Wait is Over!

Since 1983, 7,817 children have joined their families

44 have families, since January 1, 2015

  • 57% belong to a minority group
  • 78% are 9 years old or older
  • 40% are 14 years old or older

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Child Desired

Important Note: Since this form is forwarded to each child's caseworker, you must submit a separate form for each child or sibling group you are interested in. Please allow 30 days for caseworkers to contact you regarding your inquiry

While not all of these fields are required, we encourage you to complete this form with as much detail as possible. The more information you provide, the better equipped the caseworker is to make decisions about matches.

Note: Please do not include special characters in your responses (i.e. * + = | or "" ). Including any special characters may interfere with your inquiry being submitted correctly.

 

Child Desired

Important Note: Since this form is forwarded to each child's caseworker, you must submit a separate form for each child or sibling group you are interested in.

 
   
   

   

  Applicant Information

*

Name:

 

 

 

 

       

*

*

 

*

City/State/ZIP:

 

    

*

*

 

 

*

Date of Birth:


 

 


 

 

   

  Marriage Information
*

   

   

   

 
Question - Not Required - Applicant #2 Gender:

 

 

   

  Family Information

The information requested below is very important to each caseworker. Please be sure to select or provide answers and information thoroughly in each drop-down box and text field below on each inquiry you submit.
   

 

  If yes, please indicate which type(s):

 

 

 

 

 

(Maximum response 255 chars, approx. 5 rows of text)

 

*

(Maximum response 255 chars, approx. 5 rows of text)

  Home Study Information
*.

   

  Date is required to be considered as a Homestudied family.
Correct information is critical to your inquiry process.


   

   

   

   

 

(Maximum response 255 chars, approx. 5 rows of text)

 

  Adopted Child Information
 

 

 

   

 

  Preferred Ethnicity (choose "yes" for all that apply)
 

 

 

 

 

 

 

  Please check the most severe degree of special need a child has that you would consider:
 
Question - Not Required - Emotional:
 
Question - Not Required - Physical:
 
Question - Not Required - Mental Retardation (cognitive disabilities):
 
Question - Not Required - Learning Disability:
 

  Choose "yes" for all that you would consider:
 

 

 

 

 

 

 

 

 


   

 


 

Note:It may be useful for you to type up your response in a word processing application and using Ctrl + C to copy and Ctrl + V to paste the text in the field below.

Comments:

 

 
Question - Not Required - Information Desired:

  Information provided in this form will be entered into our database and may be forwarded to caseworkers and/or agencies as a potential match for other children.
 
Question - Not Required - Date Submitted
 
   Please leave this field empty

     

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