Special Needs Pre-Qualification form

If you would like to have the passwords to access the waiting children on our website (http://www.asiadopt.org/pages/waiting_children/current_waiting.html) when they become available please copy and paste the form below, fill in your answers and e-mail it to Marci at marcisk@asiadopt.org. If you qualify, she will send you the password that will allow you to view all of our available waiting children in China. CCAA may be willing to make some exceptions for families adopting older children. All of your information will be kept confidential and only used to notify you of future waiting children.


Name:

Mailing Address:

City/State/Zip:

Phone Number:

E-Mail Address:


Your ages:

Are you married? If so, what was the date of your marriage?

Have you or your spouse been divorced? If so, how many times?

Annual Income:

Do your net assets reach $80,000 or more?

What are you and your spouse’s highest levels of education?

Do you or your spouse have a criminal record?

What are you and your spouse’s BMI: http://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htm

Do you or your spouse have any health conditions?

Number of children in your home:
How long have you had them?

Do you have a home study completed or in process?

Is your dossier in another country?
If so, why do you want to view ASIA’s waiting children?

How did you hear about ASIA?

State that you “agree” or “disagree” to the following statement:

“I recognize that ASIA regards the information about children in its Waiting Child program to be private and confidential. If I am granted access to this information, I agree that I will only use this information personally in my own quest to adopt a child with special needs. I will not give the password and access information to anyone. I will not share or disseminate (including cut and paste) any of the information contained on the site.”