• Agape Adoptions Application Form

  • Agape Adoptions dba Americans Adopting Orphans
    1410 Main Street, Sumner, Washington 98390 Phone: 253.987.5804
    FAX: 253.987.7657 • www.agapeadoptions.org

  • All contents of this application are confidential and for internal use only by Agape Adoptions dba AAO.

    Please answer all questions. If a question does not apply to your family, please enter 'N/A' where possible.

    I/We understand that the information below is true and accurate to the best of my/our knowledge. It is understood that the $300.00 application fee is non-refundable. Upon receipt of the application and $300.00 fee, Agape Adoptions will process the application to determine my/our initial acceptance to adopt domestically, or internationally. Agape Adoptions will send agreements, grievance information, waiver of liability, and adoption risk statement for the applicant(s) review and signature. Upon receipt of the documents, the applicant(s) will be accepted to begin the adoption process through Agape Adoptions.

  • Please indicate which service(s) you are applying for with Agape Adoptions.

  • If you are using another agency for either Home Study or Program Services, please complete the following information for that agency.

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  • Mother

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  • FATHER

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  • MARITAL STATUS

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  • Previous Marriage(s): Mother

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  • Previous Mariage(s): Father

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  • CHILDREN

  • Children From This Marriage For each child include the following: name, date of birth, place of birth, reside at home, adopted, adoption date, adoption country, US Adoption Decree

  • Children from Previous Marriages/Relationships
  • HEALTH INFORMATION

  • Do you have any medical issues?

  • If yes, include Condition, Age at the time of diagnoses, Treatment, Prognosis, Outcome, Ongoing Treatment, and medication (if any)
  • Have you received counseling?

  • If you checked YES, please provide details regarding the reason(s) and dates of counseling (an additional statement or letter from the counselor/therapist may be required).

  • Mental Health Medications (past and present)

  • Are you infertile?
  • CURRENT EMPLOYMENT

  • Mother:


  • Father:

  • EDUCATIONAL BACKGROUND


  • CRIMINAL HISTORY

    It is required that you or anyone living in your home disclose any criminal or child abuse incident, even if it did not result in arrest or conviction, including juvenile arrest/expunged records. Failure to disclose will impact your adoption process.
  • Have you ever been arrested or convicted of a crime?

  • Have you ever been involved with substance abuse?

  • Have you ever been involved in child abuse, sexual abuse or domestic violence?

  • Have you ever had a child removed from your home?

  • Have you ever been involved with CPS?

  • ADDITIONAL ADULTS (ages 17 and older) IN THE HOME

    Provide the following information for any person age 17 or older residing in the home (including adult children, tenants/renters, in-laws, persons living on property, etc.)
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  • EMERGENCY CONTACT INFORMATION

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  • ADDITIONAL INFORMATION

  • STATEMENT OF UNDERSTANDING

  • I/We understand that there are inherent risks in international adoption and realize that any country has the authority to close adoptions, if they should so decide.

    I/We understand that Agape Adoptions provides an outline of current eligibility requirements and that any country can change the requirements or procedures during the adoption process.

    I/We understand that information on health and all other matters received through Agape Adoptions is based on all available information sent by adoption officials in the foreign country. Agape Adoptions will provide all information they have received to me/us.

    I/We understand that although foreign countries will classify children as healthy, ALL children adopted through international adoption possess the risk of having minor to significant development and/or speech and language delays often associated with institutionalism or orphanage care. Additionally, children may have other minor to significant medical needs in association with institutionalism such as malnutrition, rickets, scabies, head lice, skin rashes, etc.

    I/We understand that items such as fingerprints and immigration statuses have expiration dates and adoptive parents are ultimately responsible for any lapses in these documents. Expiration of the above stated documents can significantly increase both the in-country costs and the length of the adoption process; if allowed to expire before travel to the foreign country. Further, I/we understand that the US Consulates cannot issue a child's visa unless all immigration information is current.

    I/We understand that there are certain documents for the dossier which are time sensitive and must be submitted within a particular time frame. Agape Adoptions will provide these time frames (listed in the dossier checklist). However, parents are ultimately responsible for all paperwork submitted and ensuring all documents are filled out completely and dates are within the range given. Failure to do so can cause serious delays in the adoption process after submittal of the dossier to the foreign country.

    I/We understand that the above information is true and accurate to the best of my/our knowledge. It is understood that the $300.00 application fee is non-refundable. Upon receipt of the application and $300.00 fee, Agape Adoptions will process the application to determine my/our initial acceptance to adopt domestically, or internationally. Agape Adoptions will send agreements, grievance information, waiver of liability, and adoption risk statement for the applicant(s) review and signature. Upon receipt of the documents, the applicant(s) will be accepted to adopt through Agape Adoptions.

    The signing of this application, the applicant(s) understand and accept these terms and conditions of domestic and international adoption.

  • I understand and agree to the terms and conditions stated above.

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