China Program Korea Program Adoption Process Application Waiting Children

AAC Adoption and Family Network, Inc.
735 East HWY 56 Map
P.0. Box W
Berthoud, CO 80513

Phone: (970) 532-3576
Fax: (970) 532-9879
Email:

Members

Member Of Joint Council on International Children's Services

Adoption Application

To be considered as an adoptive parent/family, please fill out the following pre-application and mail your $25 application fee to:
AAC Adoption and Family Network, Inc.
735 East HWY 56
P.0. Box W
Berthoud, CO 80513

You can also print out the Printer Friendly Form and mail it with your $25 application fee to the address above. (The application is in PDF format. You will need Adobe Reader to open the file. If you do not have Adobe Reader, CLICK HERE to download a free version)

Before completing the application, please feel free to call us with any questions you have about our agency or our programs.

Please make sure you meet the requirements for the country you are applying for before you send your application.

Phone: (970) 532-3576 or (303) 444-5001 (in Metro Denver)
Fax: (970) 532-9879

General Information:

Family Name:

Address:

Address 1:	*
Address 2:
City:	*	State:	*	Zip:	*
Country:	*

Home Phone:

Alternate Phone:

Husband's Information:

Husband's Name:
Date of Birth:
Race:		Religion:
Height:		Weight:
Number of Previous Marriages:
Income:
Daytime Phone:
Email Address:

Wife's Information:

Wife's Name:
Date of Birth:
Race:		Religion:
Height:		Weight:
Number of Previous Marriages:
Income:
Daytime Phone:
Email Address:

Family Information:

Household annual income:		Net worth:
Date of Marriage:
Number of Children:		Children's Ages:
Number of Children Adopted:

Other Information:

Do you or your spouse have any major health concerns or history of health issues? (Ex. diabetes, cancer)


Have you or your spouse ever been treated for depression or mental illness?


Have you or your spouse had any arrests, charges and/or convictions of any criminal offense? (ex. DUI, trespassing)


Have you or your spouse ever been involved with illegal drug use?

Adoption Information: Have you had a home study done before?
If yes, date:
Homestudy Agency:
Agency Address

Address 1:
Address 2:
City:	State:	Zip:
Country:

Do you have any previous adoption experience? If yes, provide the date.

Have you ever experienced an unsuccessful adoption? If yes, please explain:

Which Program are you interested in?
What type of child are you interested in adopting? BoyGirlEither
Age:
Siblings?
Waiting Child?
Please Share your reasons for adoption:

Will your insurance cover the child upon arrival?
Will any pre-existing conditions be covered?
How did you hear about our agency?

Other Comments?

** Colorado Families **
It is a requirement of A.A.C. that families interested in our programs participate in a pre-adoption meeting. Please call our office for appointment.

Statement of Understanding

By clicking on the "Agree/Submit" button below I/We signify that: To the best of my/our knowledge, the attached information is true.

I/We have thoroughly read the information regarding the A.A.C. adoption programs | and would like to receive a formal application packet.

I/We understand that the application fee of $25.00 is non-refundable, and that it does not guarantee the receipt of a formal application, and that our application will not be processed until the fee is received by mail.

A.A.C Adoption and Family Network Inc. is an International Korean Adoption and Chinese Adoption Agency
Take the first step in adopting a child from China or Korea by filling out the AAC Adoption Application.

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