You can download REEAA Application by clicking link on left, and submit it by mail, fax, or email attachment.
To expedite the process, please use an application form below:
| Prospective Mother: |
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Last Name:
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First Name:
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Middle Initial:
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Age:
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Date of Birth:
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Citizenship:
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Passport Number:
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Occupation:
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Employer:
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Work Phone:
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May we contact you at work?
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If yes, how should we identify ourselves?
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Mobile Phone:
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Email Address:
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| Prospective Father: |
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Last Name:
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First Name:
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Middle Initial:
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Age:
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Date of Birth:
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Citizenship:
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Passport Number:
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Occupation:
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Employer:
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Work Phone:
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May we contact you at work?
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If yes, how should we identify ourselves?
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Mobile Phone:
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Email Address:
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| Home Address: |
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Street Address:
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City:
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Postal Code:
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Country:
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Home Phone:
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Fax:
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| How did you learn about REEAA? |
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| Have you ever applied to another adoption agency? |
No
Yes |
If YES, name of agency:
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| Date of marriage: |
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| Name(s), Gender, and Age(s) of other children living in the home: |
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| Gender and Age of child you are wishing to adopt: |
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| Would you be willing to consider a Eurasian child? |
No
Yes |
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| Have either of you ever been treated for alcoholism or drug addiction? |
No
Yes |
If YES, please explain:
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| Has anyone in your immediately family ever been diagnosed or treated for a mental illness, alcoholism, or substance abuse? |
No
Yes |
If YES, please explain:
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| Have either of you ever been charged with or convicted of any misdemeanor or felony? |
No
Yes |
If YES, describe nature of event and dates, even if records have been sealed or expunged:
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| Have either of you ever filed for bankruptcy? |
No
Yes |
If YES, please explain:
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| Have either of you ever been diagnosed with cancer or any chronic disease? |
No
Yes |
If YES, please explain:
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| Are either of you currently under a physician’s care for any medical reason? |
No
Yes |
If YES, please explain:
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| Please list all medications that either of you are taking on a regular basis: |
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| Are you taking medications for depression, anxiety, or any mental health condition? |
No
Yes |
| Message or any additional information: |
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We would like to apply for an adoption through REEAA. By clicking a "Submit" button below, we agree to disclose fully and truthfully any required
information for the completion of the adoption process.
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