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Thursday17 April 2014

Client Registration

* Indicates a required field

I am registering for:
Full Service: I/we live in WHFC's full service area in the Northeast (CT, MA, NH, NJ, RI, VT, and parts of NY) and will use a regional WHFC office for home study and post-placement services
Marital Status: Single
I/we have completed an adoption: No

Please complete all required fields!

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  2. Personal Information

    1. Husband or Single Applicant
    2. First Name *
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    3. Middle Name
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    4. Last Name *
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    5. Date of Birth (mm-dd-yyyy) *
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    6. Place of Birth *
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    7. Citizenship *
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  3. Address *
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  4. City *
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  5. State *
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  6. Zip code *
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  7. Country
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  8. Email *
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  9. Phone Number (xxx-xxx-xxxx) *
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  10. Fax Number
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  12. Employment Information

    1. Husband or Single Applicant
    2. Occupation *
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    3. Employer *
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    4. Number of Years w/Employer
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    5. Work Phone *
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    6. Work Fax
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    7. Work Email
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  13. List Children from all Marriages / Relationships

    1. Name
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      1. Living with You
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      2. Age
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    2. Gender
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    3. Date of Birth (mm-dd-yyyy)
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    4. Date of Arrival (if adopted, yyyy-mm)
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    5. Country of Birth (if adopted)
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    1. Name
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      1. Living with You
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      2. Age
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    2. Gender
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    3. Date of Birth (mm-dd-yyyy)
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    4. Date of Arrival (if adopted, yyyy-mm)
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    5. Country of Birth (if adopted)
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  14. Additional fields needed (please select number):

  15. Other Members of Household

    1. Name
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    2. Date of Birth (mm-dd-yyyy)
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    3. Relationship
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    1. Name
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    2. Date of Birth (mm-dd-yyyy)
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    3. Relationship
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  16. Age & Country Preferences

  17. If known, please indicate the preferred age range of the child you would like to adopt
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  18. Do you have a strong preference for country/countries of birth?
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  19. If yes, which ones?
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  20. If other, please specify
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  21. Concurrent Adoption

  22. Do you currently have an adoption in process? *
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  23. If yes, please explain
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  24. Do you have a pre-existing log in date (LID) for an adoption from China? *
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  25. If yes, please explain
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  26. Gender Policies

  27. Policies guiding gender choice are based on the needs of particular countries. Families are encouraged to be flexible about requesting and accepting children of either gender. If you wish to request a specific gender, the following policies apply:

    • You may request a boy in any program except China.
    • You may request a girl if you are adopting from China. Other programs allow families to request a girl under certain circumstances; for more information, please refer to the program-specific guidelines available from WHFC.


  28. Comments
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  29. * Invalid Input