Welcome to the Merry-Go-Round adoption search registry form. Please fill out all info that you have available. Name and address are REQUIRED. No registry will be accepted without these. If you are searching for someone under the age of 18 or are someone under 18 then you will not be added to the registry until your 18th birthday, as it is illegal for me to do so.

Your phone number (with country, city, area codes):

Address:
City/Town:	State/Prov.: Post./Zip Code:
Country:

If Match is made, do you want your phone number, email address given to the match? Yes No
What was the sex of the adoptee? Male Female unsure
Multiple Birth If Multiple birth, please give details:

Are you the adoptee, birthmom, birthdad, birthsibling, or other?
adoptees date of birth:
City and State where adoptee was born:
Hospital where adoptee was born:
Agency that handled the adoption? State Private Other, Explain:
Doctors Name:
Lawyers name:
Judges name:
Social Workers Name:
Birth Mothers Name:
Birthmothers address:
Birthmothers age when adoptee was born:
Birthmothers date of birth:
Birthmothers ethnic background:
Birthmothers other children:
Birthmothers description:
Birthmoms marital status:
If married, was she married to birthfather at time of birth?:
Birthfathers name:
Birthfathers address:
Birthfathers age at time of adoptees birth:
Birthfathers date of birth:
Birthfathers ethnic background:
Birthfathers other children:
Birthfathers marital status:
additional comments:

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