Adoption Application

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Thursday17 April 2014

Packet B - Vermont

Please be sure to read all instructions carefully, especially those related to the State of Vermont Criminal Background Checks and U.S. Citizenship and Immigration Services (USCIS).

We recommend you begin gathering these documents as soon as possible. Unless otherwise directed, you may send documents to WHFC as you receive or complete them, or submit all documents at once. Remember that we are here to help you every step of the way! Please don't hesitate to contact us if you have any questions or concerns.

You may find it easier to print this checklist and use it as you complete the necessary paperwork.

WHFC Forms

MEDICAL STATEMENT
Complete one for each person living in your home
Last updated: 3/30/2009 (60k - 2pp)

RELEASE OF COUNSELING INFORMATION
If applicable
Last updated: 6/5/2008 (48k - 1pp)

AUTHORIZATION FORM
To release criminal conviction record information
Last updated: 5/13/2009 (64k - 1pp)

AFFIDAVIT OF HEALTH INSURANCE COVERAGE
Signed by either your employer or health insurer
Last updated: 1/1/2009 (63k - 2pp)

THREE (3) LETTERS OF REFERENCE
See enclosed instructions
Last updated: 9/20/2010 (77k - 2pp)

DOCUMENTATION OF ARREST HISTORY
If applicable. See enclosed instructions
Last updated: 3/10/2009 (24k - 1pp)

Government-Issued Documents

BIRTH CERTIFICATE*
One (1) original or copy for each applicant

MARRIAGE LICENSE/ CERTIFICATE*
If applicable, one (1) original or copy

FINAL DIVORCE DECREE(S)*
If applicable, one (1) original or copy for each applicant

*NOTE: These documents must be civil (government-issued) records where the event was registered. We recommend obtaining at least five (5) original or certified copies (copies with an official raised seal) of all legal certificates for future use in completing adoption program dossiers and U.S. legalization procedures.

Criminal Background & Child Abuse Checks

BACKGROUND CLEARANCE COVER PAGE
Last updated: 9/20/2010 (73k - 1pp)

BACKGROUND CLEARANCE INSTRUCTIONS (Required for Home Study)
Last updated: 11/14/2012 (43k - 1pp)

CHILD ABUSE CLEARANCE CHECKLIST
Last updated: 11/14/2012 (46k - 1pp)

DEPARTMENT OF MOTOR VEHICLES REQUEST
Last updated: 11/23/2009 (400k - 2pp)

CHILD SUPPORT RELEASE
Last updated: 11/13/2006 (56k - 1pp)

Filing Procedures for Immigration

I-600A FILING INSTRUCTIONS
Last updated: 02/27/2013 (65k - 9pp)

I-800A FILING INSTRUCTIONS
Last updated: 02/27/2013 (70k - 9pp)

Please mail to the address below after making copies for your records.

Wide Horizons For Children
38 Edge Hill Road
Waltham, MA 02451
Attn: Applications Coordinator