Application for Adoption Services CONTACT INFORMATIONAdoptive Parent 1 Full Name Adoptive Parent 2 Full Name Work # Work # Cell # Cell # Email Email Home # Home # Home Address Parish/County PERSONAL INFORMATIONAge Age Occupation Occupation Employer Employer Do you have a current home study? (Select one) Yes No if Yes, prepared by Date of home study Name of Contact Telephone Number MARRIAGE AND FAMILYDate of Marriage Where Any Prior Marriage? If yes, please list dates of divorce Any Children? If yes, please list names and DOB Interest and Hobbies ETHNIC BACKGROUND (For Example: Hispanic, Native American, French, African American, Irish, Italian, Etc.)Adoptive Parent 1 Adoptive Parent 1 POST-ADOPTION CONTACTWhat contact are you willing to have with your birth parent(s) during the adoption process? Ex.: Phone, email, text, Facetime, Skype, or in-person What contact are you willing to have with your birth parent(s) after the his/her parental rights have been terminated? Ex.: Phone, email, text, Facetime, Skype, or in-person REASONS YOU WANT TO ADOPT Who referred you to Morris, Lee, Bayle & Willis, LLC?: If no referral, how did you learn about Morris, Lee, Bayle & Willis, LLC? COMMENTS