Faith-Based Adoption Home Study Questionnaire

Personal Information

Full Name Date of Birth Address Email Phone Number

Family Background

Marital Status Single Married Widowed Divorced Other Name of Spouse (if applicable) Children in Home (Names and Ages)

Faith Information

Religious Affiliation Church Attended Pastor or Faith Leader Contact Describe Your Faith Journey

Adoption Motivation & Parenting

Why do you wish to adopt? Describe your approach to parenting. How will your faith influence your parenting?

Household & Community

Describe your home and neighborhood. Describe your community involvement.

References

Faith Reference (Name, Relationship, Phone) Personal Reference (Name, Relationship, Phone)