Preliminary Application


Congrats on taking the first step in your adoption journey! 
 
AGCI’s Preliminary Application is provided at no cost and with no obligation in order to help determine which adoption programs are the best fit for your family. 
 
Upon submission of this Preliminary Application, you will also receive a password to view our Waiting Children page. The countries we work with require this process to help protect the privacy and security of their waiting children. Please note that over 90% of the children who we place into loving families never appear on our Waiting Children page. As we become aware of children in need of a family, we immediately work to match those children with the committed families who have gone through our application process. Our Waiting Children page is reserved for children who need a little extra help finding the perfect family.

Our Adoption Advisor will review your Preliminary Application within one business day and will reach out to you to answer any questions and discuss the next steps in your adoption journey.  Our Adoption Advisor is happy to share more about the children who we have recently united with families.

Thank you for the opportunity to serve you! 

 

Prospective Adoptive Mother
Mother Last Name*
*
Mother*
*
Mother Preferred Name
Mother DOB*
*Calendar
Applicants must be at least 23 if married, 25 if single.
Mother Citizenship*
*Show All Countries
Mother Education Level
 
Mother's Occupation*
Mother Height*
*
Enter in inches (in).
Mother Weight*
*
Enter in pounds (lbs).
Prospective Adoptive Father
Please leave all Father fields blank if you are a single applicant.
Father Last Name*
*
Father First Name*
*
Father Preferred Name
Father DOB*
*Calendar
Father Citizenship*
*Show All Countries
Father Education Level*
* 
Father's Occupation* *
Father Height*
*
Enter in inches (in).
Father Weight*
*
Enter in pounds (lbs).
Marriage
Marital Status*
 
Marriage Date (if applicable)*
*Calendar
Father Number of Previous Marriages (if applicable)*
*
Mother Number of Previous Marriages (if applicable)*
*
Number of Bedrooms in Home*
Family Information
Street Address*
Street Address Line 2
City*
State/Region*
Enter Region
Zip Code*
Country
Show All Countries
AGCI provides adoption services for U.S. citizens living in the United States.
Are you currently providing foster care?*
Are you contracted with another agency and/or pursuing another adoption at this time?*
Financial Information
Combined Annual Gross Income* $
Total Assets (everything you own of cash value) (i.e. - market value of home, savings, investments, 401 K, blue book value of car(s))*
Total Liabilities (everything you owe) (i.e. - mortgage, car loans, student loans, credit card debt)*
Net Worth (total assets minus total liabilities)*
Health & Criminal Information
Has either applicant, or a household member, ever been arrested?*
Applicants with Felonies are not accepted by any of our current programs.
If yes, please provide details of the arrests (misdemeanor, felony, DUI).*
*
Do you own any firearms?
Are you currently pursuing infertility assistance?*
Does either applicant have a current and/or past medical or mental health diagnosis?*
If yes, please explain.*
*
Does either applicant have a history of substance abuse?*
If yes, please explain.*
*
Contact Information
Best Number to Call?*
()-ext
Enter Int'l Number
Home Phone
()-ext
Enter Int'l Number
Home Email*
Would you like a FREE Adoption Consultation?*
Best Time to Call
 
Would you like to hear about our monthly Child Sponsorship program?
Other Persons/Children in Family Home

Please list all children (related and unrelated) that the prospective adoptive father and prospective adoptive mother have, as well as any adults (related or unrelated) living in the family home. This includes any children who are currently attending college but come home on weekends and/or for extended vacations, as well as children who are in the custody of their parent 50 percent or more of the year.

If any of your children were adopted, please include a letter from your previous agency, on their letterhead, confirming post-adoption compliance.

  Persons in Family Home
Children Not in Home

Please list all children that the prospective adoptive father and prospective adoptive mother have, that do not currently live in the home. This includes children attending college that do not come home on weekends and/or extended vacations, children whom you do not have 50 percent yearly custody of and any children that you have either lost parental rights of or have no relationship with.

If any of your children were adopted previously, please include a letter from your previous agency, on their letterhead, confirming post-adoption compliance.

  Children Not in Home
Adoptive Child Preferences
  Program of Interest Child Gender Preference  
 
 
   
  Child Pref Min Age Child Pref Max Age  
       
  Are you open to siblings? Are you open to medical conditions? Are you inquiring about a specific waiting child?
Name of Child?
 
       
Why We Chose AGCI
Additional Comments
Referred by former/current AGCI family (please list name)
AGCI's Information Packet  
Responsiveness of AGCI's Staff  
Availability of Information on AGCI's Website  
AGCI's Fees  
AGCI's Commitment to Orphan Care  
AGCI's Country Programs  
Statement of Understanding
 

 

I affirm that by submitting this preliminary adoption application that the information provided is true and accurate. I further understand that failure to provide accurate or to withhold information may result in the termination of services at anytime. Additionally, I understand that approval of this pre-application does not guarantee approval of my application, a home study or a placement of a child.
 
 
Submitting...
AGCI has an obligation to protect personal data and to maintain confidentiality. We honor your privacy and ensure that your data is kept confidential.