Pre-Application July 30, 2018 by Jessica Schuler $150.00 Application Please select your marriage status.*I am marriedI am not married and femaleI am not married and maleMailing Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Can we leave a voicemail?YesNoEmail* Services Requested: Please read below about home study qualifications*International Placement OnlyInternational Placement & Home Study*Home Study* & Placement for South Korea with partnership with Family and Children's Agency (FCA)Home Study* OnlyDomestic Adoption & Home Study*Post Placement*Home Study Services through CAS are only available to residents of North Carolina, South Carolina, and VirginiaPlease list placing agency, home study agency and/or attorney contact information (if applicable).*Do you give CAS permission to contact your placing agency? Yes No Homestudy and Placement InformationHow long have you lived in your current state of residence?*Marriage Date* MM DD YYYY Applicant 1Name* First Middle Last NicknameRequired if you prefer to go by a name other than your legal first nameMaiden NameRequired if applicableCell Phone NumberWork Email Cell PhoneLast 4 Digits of SSN*Date of Birth* MM DD YYYY Place of Birth (City, State)*Ethnicity (optional)Height (Required for China and South Korea Adoptions)Weight (Required for China and South Korea Adoptions)Employer*Occupation*Yearly Salary*Other Financial Resources (optional)Is this applicant a U.S. citizen?*YesNoHas this applicant been in a prior marriage?*YesNoPlease enter prior marriage dates*Has applicant ever been separated from current spouse?*YesNoN/AName, gender, and birth date of any childrenHas this applicant been treated for a medical condition?*YesNoIf yes, explain circumstances and dates.Has applicant ever undergone counseling?*YesNoIf yes, explain circumstances and dates of treatment.Has applicant ever been treated for emotional condition?*YesNoIf yes, explain circumstances and dates of treatment.Has this applicant ever been arrested, have criminal records or convictions? Please include juvenile or expunged records.*YesNoPlease provide dates and circumstancesHas this applicant ever been accused of child abuse, neglect, and/or domestic violence?*YesNoPlease provide details.Does this applicant have any history of substance abuse?*YesNoPlease provide detailsHas applicant ever filed for bankruptcy?*YesNoIf yes, please provide dates and circumstances.Applicant 2Name* First Middle Last NicknameRequired if you prefer a name other than your legal first nameMaiden NameRequired if applicableCell Phone NumberWork Email Cell PhoneLast 4 Digits of SSN*Date of Birth* MM DD YYYY Place of Birth (City, State)*Ethnicity (optional)Height (Required for China and South Korea)Weight (Required for China and South Korea)Employer*Occupation*Yearly Salary*Other Financial Resources (optional)Is this applicant a U.S. citizen?*YesNoHas this applicant been in a prior marriage?*YesNoPlease enter prior marriage datesHas applicant ever been separated from current spouse?*YesNoN/AName, gender, and birth date of any childrenHas this applicant been treated for a medical condition?*YesNoPlease provide detailsHas this applicant ever undergone counseling?*YesNoIf yes, please describe dates and circumstances.Has this applicant been treated for an emotional condition?*YesNoIf yes, please describe dates and circumstances.Has this applicant ever been arrested, have criminal records or convictions? Please include juvenile or expunged records.*YesNoPlease provide dates and circumstancesHas this applicant ever been accused of child abuse, neglect, and/or domestic violence?*YesNoPlease provide details.Does this applicant have any history of substance abuse?*YesNoPlease provide detailsHas applicant ever filed for bankruptcy?*YesNoIf yes, provide dates and circumstances.Placement PreferencesCountry you are applying for?*Gender you would like to adopt?*Number of children*Age Rangeex: 2-4 years Have you ever been turned down by an adoption agency?*YesNoIs this application for an already adopted child or child already in the home?*YesNoPost-Adoption, Relative, or Step-Parent applicants.Please provide birth name, adoptive name, date of birth, place of birth, date of adoption (if applicable) of children to be adopted/re-adopted. For Post-Adoption Only families, please also provide date of next post-adoption report.Are there any special circumstances that we need to be aware of regarding your adoption?I have read and accept the CAS Client Policies* Yes No How did you hear about us?EmailRadioEventGoogleRx BagsFacebookInstagramFriend/Family MemberOtherIf you marked "other" please specify.Did you talk to someone on our staff before completing this application?If 'Yes', please let us know who you talked to. Total $0.00 Captcha Subtotal Options Total Add to cart Category: Application