Free Adoption Application
  1. First Name:
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  2. Last Name:
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  3. Spouse/Partner's First Name:
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  4. Spouse/Partner's Last Name:
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  5. Street Address:
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  6. City:
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  7. State:
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  8. Zip:
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  9. Email:(*)
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  10. Home Phone:
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  11. Cell Phone:
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  12. Best time to reach you
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  13. How did you hear about LifeLong?
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  14. To help us determine your adoption time frame please tell us when you will be ready to start the adoption process?
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  15. Gender of Child You Wish To Adopt: LifeLong Adoptions only deals with newborn babies.
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  16. Preferred Race of Baby:
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Employment
  1. Your Occupation:
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  2. Spouse/Partner's Occupation
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General Descriptions
  1. Your Date of Birth:
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    *You must be 25 years of age or older to adopt.

  2. Your Race:
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  3. Your Hobbies, Talents and Interests:
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  4. Your Community Service:
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  5. Religion:
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  6. Spouse/Partner's Date of Birth:
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  7. Spouse/Partner's Race
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  8. Spouse/Partner's Hobbies, Talents and Interests:
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  9. Spouse/Partner's Community Service / Activities:
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Marital History
  1. Date of Marriage:
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Education
  1. Your Education Level:
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  2. Your Year Graduated:
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  3. Spouse/Partner's Education Level:
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  4. Spouse/Partner's Year Graduated
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Financial Summary (Remains Confidential)
  1. Household Income:
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  2. Own or Rent?
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Children (Please enter the age of your children and indicate if the child is adopted or biological.)
  1. Child 1 Age:
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  2. Child 1 Gender:
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  3. Child 1 Adopted or Biological:
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  4. Child 2 Age:
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  5. Child 2 Gender:
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  6. Child 2 Adopted or Biological:
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  7. Child 3 Age:
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  8. Child 3 Gender:
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  9. Child 3 Adopted or Biological:
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  10. Child 4 Age:
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  11. Child 4 Gender:
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  12. Child 4 Adopted or Biological:
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Personal History
  1. Declared Bankruptcy?
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  2. Been under psychiatric care?
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  3. Dishonorable discharge from the military?
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  4. Been arrested?
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  5. Placed a child for adoption?
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  6. Past due on court ordered child support?
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  7. Explain any of the above:
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  8. Reasons for wanting to adopt:
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Lifestyle Information
  1. Describe your neighborhood and home:
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  2. What do you enjoy doing together & individually?:
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  3. How will your life change after adoption?:
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Home Studies
  1. Have you completed a home study?
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  2. Completed home study by?
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  3. Signed up with other adoption agencies?
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  4. Names and numbers of other agencies:
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Photo
  1. Please Upload a Photo
    Choose File
Read & Submit
  1. Please note: We will contact you within one to two weeks of receipt of your complete application. Contact will be made by email or phone.
  4. Evening Phone:(*)