Request Information - More Information Form



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Are you interested in adopting a featured child?

You must have a current and completed home study in your state of residence.

You can use this form to let us know of your interest in a specific child or children. You can include as many children as you would like on each Information Request Form.

You need to include the child's or children's identification number(s) on the request form. You can find these numbers on the child's photolisting page.

Would you like more information about becoming an Adoptive Parent?

Illinois residents can request information by completing the form below and checking the appropriate box at the end of the form. If you request that information be mailed to you, it will be sent within two (2) business days. If you request a call, you will be called within twenty-four (24) hours.
Families living outside of Illinois can request information on becoming an adoptive parent in their state by clicking here.

Please fill out the following information and click the SUBMIT button Fields marked with * are REQUIRED Fields marked with ** are also REQUIRED for those with a home study
Parent 1 Name (first, last)**
Parent 2 Name (first, last)
Street Address**
Address (cont.)
City**
State
Zip Code**
Home Phone**	() -
Parent 1 Work Phone	() -
Parent 2 Work Phone	() -
Email*
	Please select any of the following options that apply:
	I have an adoption home study. Send me more information about the child. My licensing agency is:
	Agency**
	Name of Worker**
	Agency Address**
	Agency City**
	Agency State
	Agency Zip Code**
	Agency Phone**	() -
	Your Licensing Number:
	*Please enter name and ID number of the child(ren)* that you are interested in:**
	Note: You may request information about more than one child. Enter the information for each child and press the "Add Child" button. The text boxes will clear and then you can enter the information for the next child. The information for the child you added will be shown in the textboxes below.
	ALS Number	Name (or names if siblings)

	Children Added The textboxes below show the children that you are interested in.
	ALS-NUM	Name(s)

	Mail me an Adoption Information Packet at the address listed above. (Illinois residents only)
	I would like someone to call me at the phone number listed above.
How did you learn about this website: If you learned of this website from another source, please specify: