LGBT ADOPTION INFO NIGHTS: REGISTRATION FORM

Yes, I/We would like to attend the:

LGBT Info Night: Boston (6/5/12)
Your Name:
Name(s) of Other Adult Attending:

Mailing Address:

 (Number, Street)
(Apt., Suite, Floor)
(City) (State) (Zip)

Home Phone #:

Email:
 
Ethnicity:
(for demographic purposes only; please check all that apply)




If other, please specify:
 
Where are you in the adoption process?
                              Enrolled in MAPP with
                              Completing homestudy with
                              Homestudied/Waiting to be matched
                                             Date of Homestudy
                                             Agency
                                             Social Worker
                      
 Add Me/Us to MARE quarterly e-newsletter Mailing List: Yes No
Add Me/Us to Adoption Party e-Mailing List: Yes No (Adoption Parties held in Massachusetts only)
How did you hear about this event?
Additional Questions or Comments:

 

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