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Adoption Database Registry

Registration Form


You may complete this registration form to register your search in the Adoption Database Registry.

Registrations submitted without proper contact info or without payment will NOT be posted.

  

Registration Fee is $10

Due to the volume of Registrants who do not update their contact information when they move or their email address or phone number changes, we are now having to charge a $10 Registration fee to register your search in our Adoption Registry. We take each inquiry very seriously.   Unlike other Registries, we attempt to CALL you if someone inquires on your registration  ........ so it is important that we be able to reach you. We do not rely on email alone since we cannot trust that you read all your email, especially if it should go into your spam folder.  If your contact info is not current, it inflicts additional costs to us to locate you again.

Your personal information will be held in confidence and will only be used by the Registry Administrator to reach you in case of a possible match.


1. Registration Number (will be assigned)

2. I am

3. I am searching for

4. My First Name & Last Name (current)

Name

5. Email Address

E-mail

6. Re-enter Email Address

E-mail

12. If you have a Facebook account, please provide your Facebook email address which can be found at your Timeline under "About"

I understand that if I do not provide a snail mail address or telephone number, my search info will NOT be posted in the Registry.

7. Mailing Address

Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country

8. Home Phone Number

Home Phone

9. Alternate Phone Number

10. Best time to Contact if needed

11. Name of Relative or Close Friend to contact if we can not reach you

12. Their Relationship to you

13. Relatives/Friends Complete Address

13 a. Relatives/Friends Phone Number

13 b. Relatives/Friends Email Address

Selected info below will be posted in the Adoption Database Registry

14. Adoptees Date of Birth

If unsure of date, please insert range or explain here

15. Adoptees Gender

16. Adoptees Race

17. Adoptees First Name at Birth

18. Adoptees Middle Name at Birth

19. Adoptees Last Name at Birth

20. Adoptees City of Birth

21. Adoptees State of Birth

22. Adoptees County or Providence of Birth

23. Adoptees Country of Birth

24. Birth Mothers First Name

25. Birth Mothers Middle Name

26. Birth Mothers Maiden Name

27. Birth Mothers Last Name at Birth

28a. Birth Mothers Age at time of Birth

28b. Birth Mothers DOB, if known

29. Her regular City & State of Residence at time of Birth

30. Birth Mothers Occupation

31. Birth Fathers First Name

32. Birth Fathers Middle Name

33. Birth Fathers Last Name

34a. Birth Fathers Age at time of Birth

34b. Birth Fathers DOB, if known

35. His regular City & State of Residence at time of Birth

36. Birth Fathers Occupation

37. Birth Mothers & Birth Fathers Marital Status
(Married, Unmarried, Divorced - Please explain)

38. Hospital of Birth

39. Doctor

40. Name of Adoption Agency

41. If private adoption, name of attorney or firm

42. County or Providence Adoption took place

43. City Adoption took place

44. State Adoption took place

45. Adoptees Age when Relinquished to Adoptive Parents

46. Adoptees First Name after Adoption

47. Adoptees Middle Name after Adoption

48. Adoptees Last Name after Adoption

49a. Adoptive Mothers First & Last Name

49b. Adoptive Mothers Maiden Name

50. Adoptive Fathers First & Last Name

51. Date Adoption Finalized

52. Did Adoptee have older/younger siblings when relinquished for adoption
(Give Details -DOB or ages, sex)

53. Amended Birth Certificate Number

54. Original Birth Certificate Number (if known)

55. The Adoption Database Registry is open for public viewing and is easily pulled up in various search engines. If someone inquires on your registration, do you give the Registry Administrator your permission to provide your email address to the inquirer so they may contact you directly?

56. Have you applied for your NON ID information from the adoption agency or state vital records?

57. Have you registered with the ISRR (International Soundex Reunion Registry)? If not, download the registration form at http://www.isrr.net/registration.shtml and mail it in.

58. I hereby agree that I take full responsibility for posting my search information, and furthermore shall not hold the Adoption Database, nor any of its associates liable in any way .

59. You are invited to join our free Adoption Database Search & Support Group to exchange search ideas with other Triad Members and to receive assistance from many Search Angels within our Group.  

60. If you replied "yes" to #59, please select one of the mail options as to how you would like to receive email from other Group members.  We currently have over 4,800 members so our Group is very active.  If you don't check your mail box each day, we advise you to select Digest delivery version or you may set up a Google.com account to read the messages at the Group Site. 

61. How were you referred to Adoption Database?  

62. OPTIONAL: Adoption Database has teamed with ABC Producers of Extreme Makeover who are piloting the reality show "Find My Family" about search and reunion, featuring families reuniting after years of separation due to an adoption.   There is no cost involved for their assistance, except your agreement to film and air your search and reunion on their upcoming series if all parties are in agreement to do so. 

I am interested in the ABC Search & Reunion TV series "Find My Family" and would like the Producers to contact me   

63. Additional Comments (capable of lengthy comments)

Please allow a few moments for registration form to transmit.

*Note: If you are adoptee searching for another sibling(s) who has been adopted, please complete this registration form with YOUR information. You may complete another registration for the sibling, if you know their information at no additional charge. You can provide any explanations in Comment area.





 




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