Sponsorship: New Child Intake

Child Profile

Child ID Number

Enter International

Date Form Completed*

First Name *

Last Name *

Child Birth Date *

Gender *

Original Location Country*

Location Region*

Sponsor Child Location Type*

If so, what is their current job and how many hours per week do they work?

Reason for Seeking Sponsorship*

Child Status*

Full Orphan

Half Orphan

Other

Child's Mother

Home Phone

Enter International

Is Mother Living?*

Yes

If mother not living, please explain:

Employment Status

Details on Mother's Employment:

Child's Father

Home Phone

Enter International

Is Father Living?*

Yes

If father not living, please explain:

Employment Status

Details on Father's Employment:

Family History

NOTE: Please also complete the SIBLING section at the bottom of this form if the child has siblings.

Does the student have siblings? *

Yes

Are parents divorced?

Yes

If yes, how old was the child at time of divorce?

Are parents married?

Yes

Legal Guardian*

Legal Guardian's Relation to Child*

If other, please explain their relationship to the child:

Economic

Please describe the economic condition of the child's family:*

Medical

Please list any medical conditions the child has been diagnosed with:

Education

Child Grade When Entered Program*

Currently Enrolled in School?*

Yes

If not, why not in school?

School Name *

Did they graduate to the next grade level after their most recent year?

Yes

If not, why did they not move up?

Favorite Subject in School*

Main Difficulties in School*

Main Successes in School*

Developmental / Social

What do they enjoy doing for fun or in their free time? *

What is their favorite food? *

What do they want to be when they grow up?*

Child's Key Personality Trait #1:*

Child's Key Personality Trait #2:*

Child's Key Personality Trait #3:*

Media Release

Media Release Form Received*

Yes

Signature on Media Release*

When you click on 'SUBMIT', these new child profile answers will be saved and the PHOTO UPLOAD for this child will appear.

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