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Indiana Department of Child Services

DCS  > Adoption  > Inquiry Form Inquiry Form

Required Field - Required Fields

Child Information

Please list the names and ID numbers of the Children in whom you are Interested:


Personal Info

Primary Contact
Required Field Required Field
 


Spouse/Significant Other (living in the home)

 

Required Field

Required Field


Contact Info

Please check your preferred contact method, buy fill in as many as you need.
Include an Area Code in all phone numbers. The characters () . and - are also OK to use. The Email field is required.

Required Field



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Existing Family Info

Please only include children currently living in the home.

enter ages as (1,2,3...)
None Boys Girls Both


Source of Contact





If other, please explain." with an open space for the applicant to type specifics.:


Desired Child Info

Please check all that apply.

Any Male Female
Any Single Siblings Twins

Any / All
Caucasian
African American/Caribbean/African
Arab/Middle Eastern
Asian
Hawaiian & Pacific Islander
Hispanic
Jewish
Native People (American Indian or Alaska Native)
Bi-Racial
Multi-Racial


Home Study Info





If your desired Homestudy agency is not listed in the above dropdown box. Please enter the Name of the new Homestudy Agency below.

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