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Information Request Form
Information Request Form
Please send information on CHSFS' adoption programs.
* = A required field or step.
I am interested in the following programs:
Domestic
Domestic Infant Adoption program
(for MN families only)
Minnesota Waiting Child program
An adoption program for Minnesota's older/school-age children, representing all ethnicities and spectrum of abilities.
(for MN families only)
International Programs: currently accepting new applications
Russia
Ukraine
Ethiopia
China
Korea
Peru
Nepal
Mexico
Waiting International Children (WIC) program
Send a printed
WIC
photo album
India (temporarily accepting
WIC
applications only)
Colombia (temporarily accepting
WIC
applications only)
Registrant 1
*Last Name
*First Name
Age
Marital Status
Single
Married**
If married, please fill out spouses information below.
Registrant 2
Last Name
First Name
Age
*Street Address
*City
*County
*State
*Zip Code
*Home Phone
Work Phone
*Email
*How did you hear about us?
Referral by a family or friend
Referral by an adoption agency
Referral by a partner agency
CHSFS Poster
CHSFS Publication/Newsletter
Internet search engine: Google, MSN, etc.
Workplace/HR
An Adoption Conference/Fair
Additional comments:
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