2016 Adoptive Family Portrait Project - Interested Family Responses

Question Title

* 1. Thank you for your interest to participate! Please tell us your address.
Your address will not be made public or shared. It is for internal use only; we need it to determine and confirm your Congressional district so we can identify your members of Congress.

Completing this interest form does not confirm participation. We will need to also have one of your members of Congress agree to participate as well. If they do, we will then send you a family questionnaire to learn more about your families adoption experience. Thanks again for your interest; we will begin working to engage your Congressional leaders to participate!

Parent 1 name: *

Parent 2 name (if applicaple):

Address: *

Address 2: *

City/Town: *

State: *

ZIP: *

Country: *

Email Address: *

Phone Number: *

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* 2. Did you adopt from U.S. public foster care?

Yes

No

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* 3. Did you adopt...

Older youth

Siblings

Children with special needs

A young person between 18-21

Other (please specify)

Question Title

Please email your family photo to: voiceforadoption.intern@gmail.com

Thank you for completing this interest form. We will be working to get your members of Congress to participate! When we are successful you will receive a short questionnaire so we can write a story profile to share with your policymakers.