Lifeline Adoption Application

| Resume a previously saved form
Resume Later

In order to be able to resume this form later, please enter your email and choose a password.

Welcome to Lifeline Children's Services Adoption Application

At Lifeline, we believe that adoption is a way that God gives families to vulnerable children who need to know the love of a family and the love of Christ. Our desire is to walk alongside missional families on their adoption journey and to provide necessary resources as they love, nurture, and disciple their children through the love of Christ.

We love to partner with families who see the big picture of adoption as part of God’s redemptive purpose in the world through the gospel and the personal picture of adoption as God’s divine work to set the lonely in families.


The application that you are about to fill out is your first step in starting a journey of adoption with Lifeline Children's Services.


Prior to filling out this application we would like for you to review our Before You Apply page on our website with helpful information such as a sample contract, policy and procedures, and other great information.


Your first agency payment will be due upon application acceptance. To review the fees visit: http://lifelinechild.org/financial-information/ and select the country from the menu to the left.

Process for Completing the Application
During this application you will be able to save and return to it if you need to gather information before proceeding. 


Step 1: Review the Before You Apply page on the website.

Step 2: On page 11 of the application you will be asked to write out your Christian testimony. You can prepare for that by previewing those questions first.

Step 3: Fill out all required fields in the application. 

Step 4: Pay the $300 application fee after you submit your application.

Step 5: Submit.


Once you have submitted your application, someone will be in touch with you to move forward in the process!


If you have any problems during the application please do not hesitate to email info@lifelinechild.org for assistance.


Blessings,


Lifeline Children's Services Adoption Team.


Disclosure Statement
Applicants are often concerned that if they disclose certain life events that they will be rejected by the agency or that the information will negatively impact their adoption process. Actually, non-disclosure is the most frequent reason that Lifeline has for placing a family’s process on hold or even rejecting the application or home study. The issue of disclosure is not only essential to the integrity of the home study, but it is vital in forming a professional relationship between the applicants and Lifeline. Most of the time, Lifeline is able to resolve life events that may be perceived by the applicant to have a negative impact.

Lifeline Children’s Services depends on complete and truthful disclosure from each adoptive applicant in order to provide the applicants with an assessment that reflects the true status of the family unit. Each applicant will be asked to sign the application, indicating that the information given on the application is complete and accurate. Each signature indicates responsibility for the contents of the application, even if he/she did not fill out the application him/herself. The applicants are also solely responsible for the information in the application pertaining to each member of the household, including minors and adults, and relatives and non-relatives.

So what does disclosure mean? Disclosure before, during,  and after the home study process includes answering questions truthfully and completely and volunteering information that is relevant, even if a specific question has not been asked. Disclosure includes all past, present, and pending issues. Disclosure applies to written and verbal information and begins with the first contact that applicants make with the agency. Disclosure is an on-going process. Applicants are expected to report changes at the time that they occur or as soon as the applicants are aware of pending changes.

How do we decide what is relevant? Relevance is not determined by the applicants but by home study agencies. Therefore any event that is of questionable relevance must be disclosed so that a determination on relevancy can be made by Lifeline.

We understand that if we are found to be in violation of full and complete disclosure that we may experience the rejection of the application and/or receive a rejected home study and/or have our file closed.
enter a heading
Signature












Prospective Adoptive Father





Prospective Adoptive Mother





Primary Address 











Please list information about the children that reside in your home:












List others that reside in your home:








State of Residence and Other Information










Prospective Adoptive Father

Personal Information








Employment






Education







Marriage



Health




Legal Background



Prospective Adoptive Mother

Personal Infomation








Employment






Education







Marriage


Health




Legal Background



Income and Assets

Instructions: Use only numbers when entering financial information.  Letter and symbols will cause the program not to calculate correctly. 
Prospective Adoptive Father

Numbers only no sysmbols



Prospective Adoptive Mother




Automobiles









Home




Life Insurance Policies













Finances





Indebtedness and Discretionary Spending

To Whom For What Monthly Payment Remaining Balance
Home Mortgage
Second Mortgage
Other Home Loan
Auto Loan #1
Auto Loan #2
Credit Card #1
Credit Card #2
Credit Card #3
Student Loans
Installment Loans
Personal Loan
Policy Loan Life Insurance
Other #1
Note: Monthly home mortgage and monthly autos will be calculated on the next page.  


Discretionary Spending
Do not list items included on next page or investments which are drafted from paychecks.
Monthly amount 
Church Contribution
Savings and Investments
Charity
Recreation
Other #1

Monthly Expenses



Utilities 










Car Expenses



Insurance Payments  


















Domestic Adoption Matching Form


AGE





Gender


Race






Health Status




Signature




Domestic Adoption Contact Form

This page is for Domestic Adoption Families Only
As we seek to meet the needs of birth parents, we are witnessing the increase of requests for open adoption.  Please keep in mind that as you are more open, your opportunities for placement will increase.  Also, note that all correspondence will go through the agency without releasing contact information of either party.

The following are program requirements:
* Meet the birth mother at her request.  This typically happens prior to placement.
* Provide correspondence in the form of an update letter and pictures:
- Quarterly for the first year
- Every six months to age 5
- Annually from ages 6-13
NOTE:  The couple will send updates to Lifeline electronically, and Lifeline will send correspondence to the birth family. 
* Consider additional options such as meeting the birthmother before birth and providing post-adoption visits with the child present and hosted by Lifeline up to age 3.
* Attend a training session that provides education on open adoption.
Below are optional areas of correspondence and contact.  Please mark any that you will consider
Pre-Birth Contact
Post-Placement Contact
If you choose to consider meetings with the birth parents, they can be held at a neutral location, such as the agency’s office.  Information that is given to the birthparents about yourselves would be up to you (i.e.: names, city of residence could be kept confidential).  Additional non-identifying information could be given in the form of a profile, which you will complete at a later date.
Signature




Doctrinal Foundations



Note: In this section we recommend you type the answers to these questions on a separate word document and then copy and paste them into the appropriate boxes. Save the word document for future reference when filling out grant applications.

Lifeline works with Christian families who are committed to Christ and called to adopt according to His purpose. We seek to work with clients whose gospel views are aligned with the ministry of Lifeline. Therefore, we ask you to complete the questions below. We ask that parents have a firm commitment to live according to God's Word and to teach their children the truth about who Jesus Christ is as their Lord and Savior.

Couples should complete this section together. 










Please write your personal testimony below. Address the following points and any other relevant information you want to add.





Please write your personal testimony below. Address the following points and any other relevant information you want to add.




Final Page of Application


SPECIAL Funding Opportunity
Lifesong Logo

Lifeline has partnered with Lifesong for Orphans. LIfesong is a Christian funding ministry. Lifesong believes every child deserves the love of a family and that money should never be the reason a child doesn’t have a family. While many Christian families have the desire to adopt and resources to care for a child, initial costs may keep them from following God’s call to adoption. Lifesong for Orphans helps bridge the financial gap of adoption to help bring children home. Lifesong has served hundreds of Lifeline families with matching grants, loans, and free fundraising tools.

This Special opportunity is for families accepted into the Lifeline Adoption programs

Lifesong Grants


For your convenience, completing the boxes below will serve as your electronic signature and indicate that all applicable questions in the previous pages have been answered as completely and truthfully as possible to the best of your knowledge.

Please note that your next needed action after submitting this application is to pay your application fee.  When you click SUBMIT below, you'll be automatically redirected to the payment page on our website. Once we receive your application and application fee, our team will begin reviewing your application. You should be contacted by a Lifeline representative within the next 5-7 business days.

Each of you should enter your full name, including middle name, and today's date into the appropriate box below to indicate your full agreement with and understanding of the above statements and the information on all previous pages of this application.  You may then click SUBMIT to have your application transmitted to Lifeline.
Signature




Page 9