INSTRUCTIONS FOR REGISTRY
APPLICATION
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q THE REGISTRY DOES NOT
ACTIVELY SEARCH FOR INDIVIDUALS. IT SERVES ONLY AS A CENTRAL PLACE FOR
PARTIES TO AN ADOPTION TO FILE THEIR INFORMATION AND BE MATCHED TOGETHER IF
BOTH PARTIES REGISTER.
Section
A must
be completed in full by every applicant. Adoptee should write “SELF” in the
relationship to adoptee blank.
Section
B
should be filled out as completely as possible by all applicants. However, it is
not necessary to write UNKNOWN in blanks anywhere on the form when you do not
know the response.
Section
C may
be skipped by birth family members.
Section D must be completed by LISTING THE PERSON (S) TO WHOM YOU WISH TO
RELEASE INFORMATION. In the blank space, list persons in reference to their
relationship to the adoptee, i.e., Adoptee, Adoptive Mother, Adoptive Father,
Birth Mother, Birth Father, Siblings, etc. we cannot share identifying
information between you and the person with whom you wish to be reunited until
you complete this section.
Section
E only
applies if you feel that you need a counselor and do not know who to contact.
Generally there is no free counseling available, but if you mark the “YES” box,
registry staff will try to help you contact a counselor in your area.
Section
F only
applies when the applicant does not want to be notified personally if
the person(s) they are seeking is registered. To name someone else, (or an
agency) to represent you, fill out Section F, naming your “agent”, and send a
notarized “Power of Attorney” with your application.
Section
G must
be completed with your signature and date.
The
fee for registration is $35 (check or money order only). If you are unable to
register because you cannot afford this fee, please include a statement on a
separate page, which explains your circumstances and request waiver of the fee.
If you are receiving public assistance or food stamps, please send proof of
your eligibility.
A
person who has entered information in the Registry and consented to its release
may withdraw, limit or restrict the consent to release by completing an
Application To Update Information. A person desiring
to change only an address or telephone number may do so by writing to the
Registry.
A PHOTOCOPY OF YOUR BIRTH CERTIFICATE, DRIVER’S LICENSE OR OTHER ID MUST BE ACCOMPANIED YOUR APPLICATION. Enclosing a copy of the adoptee’s birth certificate (when available) significantly reduces application processing time.
q Mail application with $35.00
(Check or Money Order) and I.D. to:
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