COMPLETELY fill out the
following if you are requesting program info:
Note: The items with a
red
star are required items!
Please make sure your e-mail address is correct
before you send. So many people type the incorrect e-mail address and
we have no way to send them information! If you have not heard
from us you may assume that your e-mail was incorrect or that
your mail bounced back so please resubmit your form.
Do not hit ENTER
until you get to the end of the form. If you accidentally do, please
just push your BACK button and redo the form.
There are significant delivery issues
to YAHOO
e-mail, so please provide an alternative address or you will not
get the info you have requested.
What particular program are you requesting
information on?
BULGARIA
CHINA
ETHIOPIA
HUNGARY
KAZAKHSTAN
MEXICO
RUSSIA
UGANDA
UKRAINE
ORPHAN HOSTING PROGRAM
HOUSE
OF ANGELS - ROMANIAN SPONSORSHIP
CHARITABLE DONATION
INFORMATION
WISH
UPON A STAR RUSSIAN - CHILD SPONSORSHIP
* Your
full name:
Spouses Name:
* Your email
address: (e.g.:
you@aol.com )
Email information is required! Please
check to see if you have typed the correct address.
* Your phone number
(with area code):
Your
work phone number:
Fax
number:
* Marital
Status: Single
Married
* Age:
* Age
of Spouse:
* Years
Married:
* Number
of children in the home:
* List
all ages of children currently in the home and those away:
Age of child you would like to adopt or host:
Number of children you wish to adopt or host:
Sex of child you wish to adopt or host: Male
Female
Either
Have you started any adoption or hosting paperwork
yet? No Yes
Some details about your family and your
interest in adoption or hosting. If you have started the process or paperwork,
what have you done so far?
If you are interested in a particular child
on the photo listing, which child?
Further comments or questions for our staff
to review, feel free to ask detailed questions here and we will
get back with you very quickly:
What particular program are you requesting
information on?
Please tell us how you heard about
us!!!
Allow time for the
request to process before leaving, and do not push the send button
repeatedly.