/ WARE Child Registration Form
WARE is a project ofNorthwest Adoption Exchange
520 Pike Street, Suite 1350, Seattle, WA 98101
206-441-7242 1-800-927-9411 206-441-7281(fax) 

Thank you for taking the time to register with WARE. Online registration is available at .

Your Information

Name / Agency Name / Region
Phone / Fax / Email
Alternate Contact / Phone / Email

Child Information

Name / AKA
Birth date / Gender Identity / Male / Female
What is the child’s race/cultural identity?
Which culture does the child identify with?
Is the child Native American? / Yes / No / If no, you may skip ICWA section. If yes, please continue to answer the following
Indian Child Welfare Act (ICWA) Considerations
Is the child enrolled in a tribe? / Yes / No / If yes, which tribe?
Is there any tribal involvement or ICWA recommendations?
Staffed by ICWA? / Yes / On (date): / No
Legal Status
Is the child legally free? / Yes / No
If yes: / Date: / Order #:
Mother: / Deprivation/
Termination: / Relinquishment:
Father: / Deprivation/
Termination: / Relinquishment:
If no, must have one / Has a termination date been set? / Yes / No / Date:
of the following: / Court order to search? / Yes / No
Written parental permission to search? / Yes / No
Siblings
Name: / Birth date: / Current placement:
To be placed with this child? / Yes / No
Name: / Birth date: / Current placement:
To be placed with this child? / Yes / No
Name: / Birth date: / Current placement:
To be placed with this child? / Yes / No
Name: / Birth date: / Current placement:
To be placed with this child? / Yes / No
Name: / Birth date: / Current placement:
To be placed with this child? / Yes / No
Placement History & Current Status
Date child came into care:
# of adoption disruptions: / # of foster/group/residential placements?
Dates & location of residential treatment?
Date of present placement: / Level of care: / Rate $
Justification for special rate:
Reasons for coming into care: / physical abuse / emotional abuse / sexual abuse
chronic neglect / in-utero alcohol use / in-utero drug use
parental alcohol abuse / parental drug abuse
parental mental health diagnosis / Other:
/ WARE Child Registration Form
WARE is a project ofNorthwest Adoption Exchange
520 Pike Street, Suite 1350, Seattle, WA 98101
206-441-7242 1-800-927-9411 206-441-7281(fax) 

Child Narrative Information

Physical description (medical issues, birth history, developmental stage):
Behavior (communication skills, social skills, habits, etc.):
Favorite activities (toys, hobbies, interests, talents):
Counseling Needs (therapies, medication, short and long term needs):
Strengths/Successes (including services child responds to):
School Status (grade, level of academic functioning, disabilities, special education, etc.):
Significant relationships (how child interacts with these individuals):
Additional information (diagnoses, evaluations, reports, SSI eligible, reason for legal risk, etc.):
Adoptive Family Considerations
What are you looking for in an adoptive family? (i.e. two/single parent(s); race/culture; family size; age of siblings; etc.)
Single parent male
Single parent female
Couple / Cultural Preference:
Children in home? / how many? / younger?
older? / gender: / female
male
Other?
Is current caregiver/foster family supportive of adoption plans? / Yes / No

Additional Recruitment Options

If this child is legally free, would you like to feature this child on the NWAE public website?
(NOTE: caseworker information is not posted on NWAE child profiles; NWAE screens families for approved homestudies before referring them to caseworkers) / Yes / No
Can this child be considered for other media recruitment opportunities?
(i.e. AdoptUsKids, Wednesday’s Child, Kidsfest, television, newspapers, magazines) / Yes / No
Would you like NWAE to refer the completed profile to any of these approved photolisting services?
NOTE: To qualify for referral child must be legally free or eligible for public recruitment / Adopt US Kids / Adopt America Network

Signature Line

Child Social Worker Name:
Child Social Worker Signature:

To complete registration please email this completed form along with pictures and any other relevant documents (ISSP, Court Order to Search) to .

Have questions? Call us anytime – 1-800-927-9411. Thank you for registering your child with WARE.