11407 Seminole Blvd. Largo, FL 33778

(727) 391-8096

Adoption Advocates Inc.

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Application

Application Form

Name of Applicant 1

Applicant 1 Date and Place of Birth

Name of Applicant 2

Applicant 2 Date and Place of Birth

Present Address

How long have you lived there?

Telephone (Home)

(Work)

Applicant 1 Email

Applicant 2 Email

Previous Address

How long did you live there?

Present Marriage (When)

(Where)

Children of Present Marriage: (Name, Age, Natural Or Adopted)

Previous Marriages: To Whom/Where/When Ended Applicant 1

Previous Marriages: To Whom/Where/When Ended Applicant 2

Children of Previous Marriage: (Name and Age)

Citizenship

Religion

Height

Weight

Hair Color

Eye Color

Applicant 1 Education

High School

Some College

Other School

College

Name/Address

Dates Attended

Major

Degree

Date of Graduation

Applicant 2 Education

High School

Some College

Other School

College

Name/Address

Dates Attended

Major

Degree

Date of Graduation

Diagnosis/Treatment

Dates

Diagnosis/Treatment

Dates

Employment: Applicant 1

Present Employer

Date Started

Position

Prior Employer

Date Started

Position

Employment: Applicant 2

Present Employer

Date Started

Position

Prior Employer

Date Started

Position

Applicant 1

Applicant 2

Arrests (Full Details Excluding Minor Traffic Violations) Applicant 1

Arrests (Full Details Excluding Minor Traffic Violations) Applicant 2

Accident

Health

Personal References

Personal References (please list 3)

Name 1

Address 1

Phone 1

Name 2

Address 2

Phone 2

Name 3

Address 3

Phone 3

Name(s)

Age

1. Have either of you ever been informed that you are infertile or do you have reason to believe that such might be the case?

2. Have you ever made an application to any other adoption agency or are you now working through another such agency?

3. What were you told about the results of any previous adoption application?

4. What age and gender do you prefer in an adoptive child?

We have read and answered the foregoing questions to the best of our knowledge. Any additional details are listed below or on the reverse side of this page.

Agree

Disagree

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We will get back to you as soon as possible.

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Adoption Advocates Inc.

Helping children and families build lasting connections through compassionate, full-service adoption support.

Contact Information

Call Tara on (727) 391-8096

Text Tara on (727) 480-8335

tara@adoptionadvocatesinc.com

11407 Seminole Blvd. Largo, FL 33778

Business Hours

Mon - Sun: Open 24 Hours

© 2025

Adoption Advocates Inc.

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