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  M F
Race
Religion
Subsidy
Travel reimbursement
Legally free for adoption?  Yes No
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 parents Siblings Foster parents Grandparents
Other relatives
Type of family being sought
 Any interested family Two parent Single parent Older children preferred Younger children preferred No 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)
 ADD ADHD Adjustment Disorder AIDS/HIV Animal Abuse Anxiety Disorder Asthma Attachment Disorder Autism Bipolar Blind Cerebral Palsy/Mild Cerebral Palsy/Moderate Cerebral Palsy/Severe Conduct Disorder Deaf Depression Developmental Delays Diabetes Down Syndrome Drug Exposed Eating Disorders Emotional/Mild Emotional/Moderate Emotional/Severe Encopresis Enuresis Epilepsy Failure to Thrive Fetal Alcohol Syndrome Fire Starter Heart Murmur Hydrocephalic Hyperactivity Learning Disability Legal Risk Macrocephalic Mental Retardation/Mild Mental Retardation/Moderate Mental Retardation/Severe Microcephalic Missing Limbs Mood Disorder Muscular Dystrophy Non-Ambulatory Non-Verbal Obsessive-Compulsive Disorder (OCD) Oppositional Defiant Disorder (ODD) Paralysis Physically Abused Physically Aggressive Post-Traumatic Stress Disorder (PTSD) Quadriplegia Reactive Attachment Disorder (RAD) Runaway Schizophrenia Scoliosis Seizures Self-Abusive Sexually Abused Sexually Acting Out Shaken Baby Syndrome Sickle Cell Spina Bifida Terminal Illness Total Care Tourette Syndrome Trach Tube 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/flier Radio TV Newspaper Internet web page Magazine Recruitment events
Worker Signature:
By selecting the "Send Application" button we take that as your permission to feature this child based on your sections above.