Grant Application — Addendum 185

Adoption Grant Application

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Adoption Story

Please include a link to a short video that introduces you and your family, and explains why you would like to be considered (unlisted youtube, etc). Or share the video file via file sharing website to info@addendum185.org (dropbox, google drive, onedrive, etc.). Applications will not be reviewed without having received a video.

Why are you choosing adoption?

Are you currently licensed foster parents with the intent to adopt through the foster system?

Are you working with any private adoption agencies? If yes, please list agencies.

Which adoption are you considering?

Have you previously had any failed adoptions? If yes, please explain.

Are you eligible for a stork drop?

Are you currently matched with a birth parent?

Have you recently adopted? How much did you pay out of pocket?

Does your employer pay adoption benefits? If yes, please list employer and benefit.