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UN:
LN:

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SO
Name:
Age:
Occupation:
Disabilities:
Hobbies:

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SO
Name:
Age:
Occupation:
Disabilities:
Hobbies:

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Current children: (names, ages, disabilities)

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Others living with you: (names, ages, disabilities)

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Pets:

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Housing
Type: (house, apartment, farm, mansion, etc.)
Location: (be as specific as you can)
Land owned:
Bedrooms:
Bathrooms:
Other:

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What is/are the household’s religion(s):
What language(s) do household members speak:
Do you travel? If so, how often and where to:

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ADOPTION
How many children would you like to adopt: (3 max)
Gender(s):
Age: (Newborn-19)
Nationality:
Languages preference:
Religion preference:
Multiples: (Specify twins, triplets, quads)
Will you accept:
--siblings:
--neighbors:
--friends:
--children with pets (of what kind and gender):
--children with disabilities (of what kind and severity):
--pregnant teen/teen mother:
--baby’s father/teen father:
Will you allow them to stay in contact with non-abusive parents/relatives?