Family Information Form

We are thrilled you are interested in learning more about adoption! Our staff will contact you soon to answer all of your questions and share with you about our programs, but first we would like to gather a little information about your family.

This form is not an application, but it will help us prepare for our conversation and tailor the information to your specific circumstances. It will also help us determine the programs you are eligible and best suited for. 
 

**Please do not submit duplicate "Family Information Forms". 
You will receive a confirmation email (to the emails you list below) with contact information for our staff, should you need to make an adjustment to your submission.  If you do not receive this email, please check your spam / junk folders.

Program's of Interest Select the programs you are interested in learning more about. *Please be advised, at this time we are only accepting inquiries & applications for our Domestic Program from Alabama Residents.   This DOES NOT apply to our international programs, China & India.   What programs are you most interested in?* India China Peru Dominican Republic Home Study Only Domestic Puerto Rico Family Report To Court Undecided / Other   If "other" please provide information here* If you have selected "Home Study Only", what type of adoption is this for?* Domestic International   Prospective Adoptive Parent #1 First Name (as listed on passport)* Last Name (as listed on passport)* Gender* Female Male Prefer Not to Answer   Date of Birth* Parent #1 Preferred Email* *Please make sure your preferred email address is listed Parent #1 Cell Number* ()-ext Enter Int'l Number Occupation* Citizenship* United States Australia Cambodia Canada China Ethiopia France Germany Guatemala India Ireland Italy Kazakhstan Mexico Netherlands Russia Sweden Switzerland Ukraine United Kingdom Show All Countries Religious Affiliation Christian Agnostic Amish Atheist Baptist Buddhist Catholic Episcopalian Hindu Islam Jewish Latter Day Saints Lutheran Mennonite Methodist No Religion Non-Denominational Presbyterian Scientology Seventh Day Advantist   Have you been married previously?* YesNo If "yes", number of prior marriages* * Please also include any marriages that might have been annulled. Have you EVER been arrested or convicted of a crime?* YesNo Do you have any chronic or debilitating medical conditions?* YesNo Prospective Adoptive Parent #2 (Spouse) If you are not married, please leave this section blank. First Name (as listed on passport)* * Last Name (as listed on passport)* * Gender* Female Male Prefer Not to Answer *  Date of Birth* * Parent #2 Preferred Email* *Please make sure your preferred email address is listed Parent #2 Cell Number* ()-ext * Enter Int'l Number Occupation* * Citizenship* United States Australia Cambodia Canada China Ethiopia France Germany Guatemala India Ireland Italy Kazakhstan Mexico Netherlands Russia Sweden Switzerland Ukraine United Kingdom * Show All Countries Religious Affiliation Christian Agnostic Amish Atheist Baptist Buddhist Catholic Episcopalian Hindu Islam Jewish Latter Day Saints Lutheran Mennonite Methodist No Religion Non-Denominational Presbyterian Scientology Seventh Day Advantist   Have you been married previously?* YesNo* If "yes", number of prior marriages* * Please also include any marriages that might have been annulled. Have you EVER been arrested or convicted of a crime?* YesNo* Do you have any chronic or debilitating medical conditions?* YesNo*

Prospective Adoptive Parent(s) Street Address* City* State/Region* AK - Alaska AL - Alabama AR - Arkansas AS - American Samoa AZ - Arizona CA - California CO - Colorado CT - Connecticut DC - District of Columbia DE - Delaware FL - Florida FM - Federated States of Micronesia GA - Georgia GU - Guam HI - Hawaii IA - Iowa ID - Idaho IL - Illinois IN - Indiana KS - Kansas KY - Kentucky LA - Louisiana MA - Massachusetts MD - Maryland ME - Maine MH - Marshall Islands MI - Michigan MN - Minnesota MO - Missouri MP - Northern Mariana Islands MS - Mississippi MT - Montana NC - North Carolina ND - North Dakota NE - Nebraska NH - New Hampshire NJ - New Jersey NM - New Mexico NV - Nevada NY - New York OH - Ohio OK - Oklahoma OR - Oregon PA - Pennsylvania PR - Puerto Rico PW - Palau RI - Rhode Island SC - South Carolina SD - South Dakota TN - Tennessee TX - Texas UT - Utah VA - Virginia VI - Virgin Islands VT - Vermont WA - Washington WI - Wisconsin WV - West Virginia WY - Wyoming Enter Region Zip Code* Are you married?* YesNo Date of Marriage* * For international adoption, the marriage requirements vary from country to country. Check the country requirements to determine your eligibility for the program to which you are applying. What is your approximate annual income? (combined annual income for couples)* $ This information is important for us to gather because some adoption programs have minimum family income requirements, and we would like to be able to best advise you when we discuss your options Do you have any children?* YesNo Have you adopted previously?* YesNo Have you (either of you) ever had a child removed from your custody or had a disrupted or dissolved adoption?* YesNo Do you have any other adult members of your household?* YesNo Adoption Questionnaire How did you become interested in adoption?* How familiar are you with International Adoption? Not familiar Semi familiar Very familiar  How familiar are you with Domestic Adoption? Not familiar Semi familiar Very familiar  How did you hear about Children of the World?

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