Adoption of a child
from overseas:
Home Office reference
number (if known)
Questionnaire
Appendix 3
Please submit this form
and the documents requested when you apply for entry clearance.
The information requested on this form includes many of the details that will be required by a court hearing an adoption application. This form and the documents that you should enclose with it will be treated as confidential and only passed to the DHSS and the local authority undertaking the home study report. In some cases we may need to ask for further information.
DETAILS ABOUT THE CHILD
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Surname
Other names
Nationality
Sex :
male
female (tick one box)
Passport Number if any
Date of birth
(Please enclose birth certificate or
a signed and attested statement giving the date of birth)
Name and address of person currently looking after the child overseas :
Is this person a relative of the child? If Yes state relationship :
Has the child attended school?
Yes No D
Yes
No
If Yes how many years has he attended school? ....... has he passed any examinations? (give details)
If the child has any brothers or sisters give:
names:
date of birth:
Years
name of person caring for them:
*PLEASE ATTACH A COPY OF THE MEDICAL REPORT ON THE CHILD, THIS SHOULD BE ON A BAAF FORM OBTAINABLE FROM BRITISH AGENCIES FOR ADOPTION AND FOSTERING 11 SOUTHWARK STREET LONDON SE1 (See attached annex on medical forms)
IF THE CHILD has beeN CARED FOR BY A PUBLIC OR OTHER ORGANISATION
Name and address of the body:
Date child came into their care:
If the child has been abandoned please attach a signed and attested statement giving as many details as possible about the circumstances in which the child entered the caring body's charge.
* Please attach a signed statement that the agency has authority to release the child for adoption abroad. This should be supported by legal evidence (this may be a court order or a letter signed by an authorised member of a governmental welfare or emigration authority).