Let us help find families for the waiting children.

For those agencies that would like to register their legally free children with us, please fill out the form below or download a printable AAN Child Registration Form, fill it out, attach a photo, and mail to:

Adopt America Network
c/o Registration Department
3100 W. Central Ave., Suite 225
Toledo, Ohio 43606

Child Registration Form

Child's name
DOB
Gender MF
Race
Religion
Subsidy
Travel reimbursement
Legally free for adoption? YesNo
Total time in care?
Months
Years
Can children be placed out-of-state/any geographic restrictions?
Are any siblings involved?
Visitation and/or contact with:
Bio parentsSiblingsFoster parentsGrandparents
Other relatives
Type of family being sought
Any interested familyTwo parentSingle parentOlder children preferredYounger children preferredNo children in home

Other

Agency
Agency address
Agency phone
Agency fax
Worker name
Worker phone
Worker E-mail
Any other additional information that would be helpful in searching for a family?
Challenges (please check all that apply)
ADDADHDAdjustment DisorderAIDS/HIVAnimal AbuseAnxiety DisorderAsthmaAttachment DisorderAutismBipolarBlindCerebral Palsy/MildCerebral Palsy/ModerateCerebral Palsy/SevereConduct DisorderDeafDepressionDevelopmental DelaysDiabetesDown SyndromeDrug ExposedEating DisordersEmotional/MildEmotional/ModerateEmotional/SevereEncopresisEnuresisEpilepsyFailure to ThriveFetal Alcohol SyndromeFire StarterHeart MurmurHydrocephalicHyperactivityLearning DisabilityLegal RiskMacrocephalicMental Retardation/MildMental Retardation/ModerateMental Retardation/SevereMicrocephalicMissing LimbsMood DisorderMuscular DystrophyNon-AmbulatoryNon-VerbalObsessive-Compulsive Disorder (OCD)Oppositional Defiant Disorder (ODD)ParalysisPhysically AbusedPhysically AggressivePost-Traumatic Stress Disorder (PTSD)QuadriplegiaReactive Attachment Disorder (RAD)RunawaySchizophreniaScoliosisSeizuresSelf-AbusiveSexually AbusedSexually Acting OutShaken Baby SyndromeSickle CellSpina BifidaTerminal IllnessTotal CareTourette SyndromeTrachTube Fed
Other conditions, syndromes, problems
(please list)

Profile of child
(Child’s personality, interests, hobbies, etc.)

Please add most recent photo
Worker: Please check and sign for permission to feature this child in any or all recruitment events available.
Adopt America newsletter/flierRadioTVNewspaperInternet web pageMagazineRecruitment events
Worker Signature:
By selecting the "Send Application" button we take that as your permission to feature this child based on your sections above.
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