Please provide your contact information so we can send your introductory packet!

Please tell us about yourself:

Salutation-- Please Select --Mr. Ms. Mrs. Dr. Prof.
First Name
Last Name
Age
Address
City
State/Province
Zip
Home Phone
Day-time Phone
Email
Marital Status -- Please Select -- Married Single

Spouse's information:

First Name
Last Name
Age
Day Time Phone

How did you hear about us?	-- Please Select --Advertisement Conference/Seminar Friend Google Homestudy Agency Other Parent that previously adopted Relative Website Word of mouth Yahoo
What services are you interested in?	-- Please Select --Homestudy Services only Country PLacement Services only Homestudy AND Placement Services Post-placement Services only
Annual Combined Income	-- Please Select --Under $30,000 $31,000-$50,000 $51,000-$75,000 $76,000-$90,000 over $90,000

About your preferences:

Number of Children -- Please Select --One Two Three or more Undecided
Age Preference-- Please Select --Up to 6 months Up to 12 months Up to 24 months 2 - 3 years 3 - 4 years 4 - 5 years 5+ years undecided
Gender Preference-- Please Select --Boy Girl either 2 - either Boy and Girl
Starting Timeframe-- Please Select --Now in 1-2 months in 3-4 months in 5-6 months in 7-8 months Later Undecided

What programs interest you? (click all that apply)

Russia Republic of Georgia Ukraine Armenia Kazakhstan China Korea

Vietnam Thailand India Ethiopia Colombia Guatemala Peru/Ecuador/Honduras

Homestudy:
Please tell us where you are in the homestudy process?
-- Please Select --What's a homestudy Need an agency Have an agency Study completed Study needs to be updated
Homestudy Agency Name:

USCIS:
Please tell us where you are in the USCIS approval process.
-- Please Select --What is USCIS I haven't started the USCIS process yet I have started the USCIS process already I have USCIS approval

Comments:
Is there anything else you'd like to share with us?