Graceful Adoptions Application

Welcome to Graceful Adoptions™!

The application process is the first step in the journey to bring your child home. It provides Graceful Adoptions the information to understand your needs and desires, allowing Graceful Adoptions to help make your dreams come true. Please complete all applicable information.

If you have any questions, please contact us at 1.877.628.1415 or YourPartner@GracefulAdoptions.com

Before you begin your Application, please ensure you meet Graceful Adoptions' Basic Eligibility Requirements:

• Be 27—45 years old
• If first marriage, be married for a minimum of two years; if second marriage, be married for five years (maximum of two marriages per parent)
• Currently parenting no more than two children
• Have a minimum total income of $50,000 plus $10,000 for each child currently living in the home as reported on line 9 of your Income Tax Return Form 1040.
• Accept either a semi-open or open Communications Plan with the parents placing the child
• Have medical insurance that will cover the adopted child at birth or placement
• Have a life insurance policy to support the family should anything happen to either parent
• Sign our Corporal Punishment Prohibited statement

We may be able to save you time by pre-filling the form with the information that you have previously entered.

Have you previously submitted your information to us?

Yes, Login

No, Begin Form

Family Address

Street Address

Street Address Line 2

City

State/Region*

Enter Region

Zip Code

County

Contact

Preferred Contact Method

Home Phone

()-ext

Enter Int'l Number

Primary Email Address*

Fax Number

()-ext

Enter Int'l Number

Applicant 1

First Name

Middle Name

Last Name

Cell Phone Number

()-ext

Enter Int'l Number

Office Phone Number

()-ext

Enter Int'l Number

Personal E-Mail

Date of Birth

Citizenship

Show All Countries

Occupation

Employer

Salary

Highest Level of Education

If married, Date of Marriage

Location of Marriage (city, state)

Applicant 2

First Name

Middle Name

Last Name

Cell Phone Number

()-ext

Enter Int'l Number

Office Phone Number

()-ext

Enter Int'l Number

Personal E-Mail

Date of Birth

Citizenship

Show All Countries

Occupation

Employer

Salary

Highest Level of Education

Adoption Home Study

Home Study Contact Email*

Home Study Agency Name

Home Study Agency Phone

()-ext

Enter Int'l Number

Home Study Agency Contact

Photo of your family so we can 'put a face with a name.'
Once uploaded, your photos will not be viewable except by agency staff for security purposes.
Photo

Password
Please enter a password to use at a later time to access other forms on our website. Please write down and keep this password in a safe place.
Family Login Password*	Password Already Set Change Password
Confirm Password	*
Password must be at least 8 characters with at least one uppercase letter, one lowercase letter, one number, and one special character.

How did you hear about Graceful Adoptions?
How did you hear about Graceful Adoptions?
If referral, who do we have to thank?
Additional Comments:

COMPLETE THE APPLICATION PROCESS
	COMPLETE THE APPLICATION PROCESS To complete the application process 1. Your Application. First, press "Print" below to maintain a copy of your Application for your records. Second, press "Submit" to send a copy of your application to Graceful Adoptions. 2. Your Application Fee. For your convenience, a request for the $450 Application Fee will be sent via PayPal. 3. Your Supporting Documents. Please email the following documents to YourPartner@GracefulAdoptions.com. Signed and Notarized Adoption Home Study Background Checks; including FBI, State Criminal, Child Abuse and Neglect, and Sex Offender Medical reports signed by the adoptive parents(s) physician Previous years Federal Taxes, pages 1 and 2 A representative from Graceful Adoptions will contact you immediately upon receipt of your Family Photo, Application, Application Fee and Supporting Documents to schedule your Application interview. We look forward to speaking with you soon! Graceful Adoptions Acceptance of the non-refundable Application Fee does not constitute approval by Graceful Adoptions that the adoptive family's Application will be approved and accepted by Graceful Adoptions.

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We focus on what matters to make every adoption a beautiful experience.

	Children	Divorce Date	Reason for Divorce
	YesNo

	Children	Divorce Date	Reason for Divorce
	YesNo

	Children	Divorce Date	Reason for Divorce
	YesNo

	Children	Divorce Date	Reason for Divorce
	YesNo

	Children	Divorce Date	Reason for Divorce
	YesNo

	Care by Applicants Required	If yes, please provide details of the care needed.
	YesNo

	Perpetrator of child abuse/sexual abuse	Criminal charges or history
	YesNo	YesNo

	Gender	Biological, Adopted, or Foster	If child is from a previous relationship/marriage, specify which parent:	If adopted, Date Adoption was Finalized

	Residing in Home	If no, location (city/state)	If child is living outside the home, specify why
	YesNo

	Perpetrator of child abuse/sexual abuse (if over 14):	Criminal charges or history (if over 14):
	YesNo	YesNo

	Alcohol
	Daily Weekly Monthly Occassionally (1-5 times) Never

	Anti-Convulsants
	Daily Weekly Monthly Occassionally (1-5 times) Never

	Anti-Depressants
	Daily Weekly Monthly Occassionally (1-5 times) Never

	Cigarettes All prospective adoptive parents must be open to cigarette use daily
	Daily Weekly Monthly Occassionally (1-5 times) Never

	Cocaine/Crack Cocaine
	Daily Weekly Monthly Occassionally (1-5 times) Never

	Diet Pills
	Daily Weekly Monthly Occassionally (1-5 times) Never

	Ecstacy
	Daily Weekly Monthly Occassionally (1-5 times) Never

	Heroin
	Daily Weekly Monthly Occassionally (1-5 times) Never

	Marijuana
	Daily Weekly Monthly Occassionally (1-5 times) Never

	Methadone
	Daily Weekly Monthly Occassionally (1-5 times) Never

	Methamphetamines
	Daily Weekly Monthly Occassionally (1-5 times) Never

	Tranquilizers
	Daily Weekly Monthly Occassionally (1-5 times) Never

	ADD/ADHD	Asthma
	Expectant Parents Immediate or Extended Family	Expectant Parents Immediate or Extended Family

	Bi-Polar	Blindness
	Expectant Parents Immediate or Extended Family	Expectant Parents Immediate or Extended Family

	Cancer	Cystic Fibrosis
	Expectant Parents Immediate or Extended Family	Expectant Parents Immediate or Extended Family

	Depression	Developmental Disorder
	Expectant Parents Immediate or Extended Family	Expectant Parents Immediate or Extended Family

	Diabetes - Type 1	Diabetes - Type 2
	Expectant Parents Immediate or Extended Family	Expectant Parents Immediate or Extended Family

	Epilepsy	Hearing Impaired
	Expectant Parents Immediate or Extended Family	Expectant Parents Immediate or Extended Family

	Hepatitis A	Hepatitis B
	Expectant Parents Immediate or Extended Family	Expectant Parents Immediate or Extended Family

	Hepatitis C	High Blood Pressure
	Expectant Parents Immediate or Extended Family	Expectant Parents Immediate or Extended Family

	HIV/AIDS	Multiple Sclerosis (MS)
	Expectant Parents Immediate or Extended Family	Expectant Parents Immediate or Extended Family

	Schizophrenia	Sickle Cell Anemia
	Expectant Parents Immediate or Extended Family	Expectant Parents Immediate or Extended Family