Please fill out the following form in order for us to make the best possible match for you and your child(ren). Only one application per person, please.
Last name:
SO1:
SO2:
Children (names, disabilities and ages):
Location:
Pets:
Languages spoken:
Language preference, if any:
Religious preference, if any:
Country/ies:
Number of children (max 4):
Gender(s):
Age(s) (0-12):
Twins?
Triplets?
Quads?
Siblings?
For all disabilities, please indicate mild, moderate or severe.
Emotional disabilities?
Social disabilities?
Mental disabilities?
Physical disabilities?
Chronic illnesses?
Thank you!
Edit: Added countries...duh!
This message was edited 12/30/2007, 6:45 PM