World Partners Adoption - Request Packet for INTERNATIONAL ADOPTION INFORMATION

Request Info Packet

Children of Kazakhstan

If you would like to receive one of our information packets, please complete the information fields below. Several are required fields that must be completed to enable the form to be sent. One field asks how you would like to receive the packet -- via email or snail mail. If you fail to check either box, the packet will be snail mailed.

If you choose to have the packet emailed to you, make sure the email address you use will accept LARGE files. The file size is one megabyte and many email addresses will NOT except it. It is sent in pdf format only and you will need an updated version of Adobe Reader to open it.

* First Name:
* Last Name:
Name of spouse:

* Email address:	All email requests are sent in pdf format only and will require Adobe Reader to open. Some emails bounce, so if you do not receive the file, or cannot open it please send an email to wpajim@aol.com to request one be mailed to you.
How would you like the information sent?	"Snail Mail" Email
Have you requested information from us in the past? Yes No

* Street address:
* City:
* State:
* Zip code:
Country:

* Phone number (home):
Phone number (husband's work):
Phone number (wife's work):
Phone number (fax):

Age of Adoptive Mother:
Age of Adoptive Father:
Years married:
Number of children in home:
Give ages of all children in home:
Number of children you wish to adopt:
Age of child desired:
Sex of child desired:	Female Male Either
Country you wish to adopt from :	Kazakstan Colombia China Ukraine Guatemala

Comments to us:

How did you hear about us?


	(If all of your information looks correct press "Send Form NOW" but if you have made errors you can press "Clear Form" to start over)

World Partners Adoption, Inc
Cindy Harding, Executive Director
2205 Summit Oaks Court
Lawrenceville, GA 30043
1- 800-350-7338
Local Atlanta: 770-962-7860
Fax: 770-513-7767
(Office Hours 9:00am-5:00pm Eastern Standard Time)
WPAJim@aol.com