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FAMILY FORM

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Last Name: Brewer

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Mother's name: Anne Elisabeth

Father's name: Cohen Jack

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Children's name & Ages: Omri James (8) and Ella Mae (5)

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Pets: cat: Dickie

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ADOPTIVE FORM

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How many children would you like to adopt? 1, 2 or 3

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Siblings? no, only when they are twins

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Twins? yes

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Triplets? no

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What gender? no preferance

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Would you be willing to handle disabilities? Which kind? yes, but only light disabilities.

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Are your current children easy going and loving? yes.

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Where do you want your child to be from? USA, Canada, Mexico

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What age? under 10

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xx-Eljah

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