CONTACT ORPHANAGE FORM

INSTRUCTIONS:  Please edit this form based on your information and email it to Adele as an attached 
file.  This will speed up the process.  (All the information in this sample sheet is fictional.)

Please email this form as an attachment to Adele at lehall88@yahoo.com  or fax it to
fax number (866) 691-1250. 

        Thank you!      -Adele

1. INFORMATION ABOUT YOU AND YOUR ADOPTED CHILD:

Adoptive parent(s):  Jim and Linda Smith 
Mailing address :  12 Winterpark St.  Minneapolis, MN 78223

Adopted child’s name:  Ning Chun Fang  

Born on: July 21, 2001 
Found on: July 22, 2001 
Adoption date:  August 22, 2003 

IMPORTANT - Please also send or fax the Chinese characters of your 
adopted child’s name.  You can email or fax Adele the Chinese characters of your child's 
name and the orphanage's name. You can find this info in the CCAA acceptance letter, 
or in your pre-approval letter, or your Letter of Intent. 


2. INFORMATION ABOUT YOUR CHILD'S ORPHANAGE:

Orphanage Name: Mei Fu City Social Welfare Institute in Jiangxi Province 
Please also send the Chinese characters of the Orphanage’s Name.

Orphanage phone:   0582-3335858  (If you know the phone number, please let me 
know.  If not, we will locate it for you.)

3. YOUR QUESTIONS FOR THE ORPHANAGE:

a. May we get digital photos of our child?

b. What are the current measurements for our child, such as height, 
weight, head & chest circumference?


4. ADDITIONAL QUESTIONS

Additional questions cost $25 each. You can type
your additional questions here and email this form to Adele. 

To pay for additional questions, you may use our payment buttons 
webpage and pay by credit card.  Please copy the link below and paste 
into your browser.

Payment buttons web page:
http://www.blessedkids.com/index_files/payment_buttons.htm