2. Date/s of Birth
5. Address of Birthparents
8. Siblings of the child to be adopted (please state their names, gender, age, and attitude towards their
sister’s/brother’s adoption)
13. Address of Child (Give the most complete address and if possible, contact number – telephone,
cellphone, fax number, email, etc.)
14. Is/Are the parents of the child/ren in touch (visit, write, phone) with the prospective adoptee/s?
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21. Name of Employer, position, length of employment of the applicants
Male :
Female :
23. Number of Children of prospective adoptive parents (indicate if living with them, their ages, and civil
status).
25. Other individuals who reside in the household (names; birthdate; relationship to applicants; attitudes
towards the adoption plan; permanently or temporarily residing with applicants; contribution, if any, to the
family income).
28. Reason for the prospective adoptive parents’ (PAPs) choice of this/these particular child/children as their
adoptee/s.
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29. Attitude of prospective adoptive child/children towards his/her/their being adopted. (If applicable,
depending on age and level of maturity of prospective adoptive child/children).
30. Description of the degree of bonding between the prospective adoptive parents (PAPs) and the
prospective adoptive child/children. [To include, among others, ways and means of nurturing relationship
(letters, phone calls, greeting cards, etc), visits to the Philippines (who visited, when, duration of stay in the
Philippines, what they id together with the prospective adoptive child/children)]
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Information Required By The Inter Country Adoption Board in the Philippines
Birthdate Husband:
Wife :
Husband:
Wife :
Income Husband:
Wife :
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Description of living accommodations (house or apartment; rental or purchasing):
Other individuals who reside in the household (names; ages; relationship to applicants; permanent or
temporary resident of the household; contributions, if any, to family income):
____________________________ ______________________________
Date Signature
____________________________ ______________________________
Date Signature
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