Adoption Application
  1. Interested in adopting from China or Korea? Whether you are just beginning to explore the idea of adoption or you are ready to jump in with both feet, the eligibility application is a great place to start. The below application will provide AAC staff with the basic information we need to know in order to verify that you meet the requirements of the program you are interested in. This will also give you access to AAC's Waiting Child Listing. If you are interested in viewing this list, simply mention the listing in the comments section of the application. Who knows, maybe your child is waiting for you to find them there!

    Note: There is no fee or obligation associated with the application. Information you provide is strictly confidential.

    If you experience any difficulty submitting the application, please let us know by emailing

  2. General Information:
  3. Family Name:*
    Please let us know Your Name.
  4. Address 1:*
    Please enter your Address.
  5. Address 2:
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  6. City:*
    Please enter your City.
  7. State:*
    Please select your state
  8. Zip:*
    Please enter your Zip Code
  9. Country:*
    Please select your Country.
  10. Phone:
    Please enter your Phone #.
  11. Alternate Phone:
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  12. Main Email:*
    Please enter your Main Email Address.
  13. Husband's Information:
  14. Husband's Name:*
    Please enter Husband's Name
  15. Date of Birth:*
    Please enter Husband's Date of Birth
  16. Citizenship:*
    Please enter Husband's Citizenship
  17. Race:*
    Please enter Husband's Race
  18. Religion:*
    Please enter Husband's Religion
  19. Height:*
    Please enter Husband's Height
  20. Weight:*
    Please enter Husband's Height
  21. Number of Previous Marriages:*
    Please enter Husband's Number of Previous Marriages
  22. Income:*
    Please enter Husband's Income
  23. Daytime Phone:
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  24. Email Address:
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  25. Wife's Information:
  26. Wife's Name:*
    Please enter Wife's Name
  27. Date of Birth:*
    Please enter Wife's Date of Birth
  28. Citizenship:*
    Please enter Wife's Citizenship
  29. Race:*
    Please enter Wife's Race
  30. Religion:*
    Please enter Wife's Religion
  31. Height:*
    Please enter Wife's Height
  32. Weight:*
    Please enter Wife's Weight
  33. Number of Previous Marriages:*
    Please enter Wife's Number of Previous Marriages
  34. Income:*
    Please enter Wife's Income
  35. Daytime Phone:
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  36. Email Address:
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  37. Family Information:
  38. Household Annual Income:*
    Please enter Household Annual Income
  39. Net Worth:*
    Please enter Household Net Worth
  40. Date of Marriage:*
    Please enter Date of Marriage
  41. Number of Children:*
    Please select Number of Children
  42. Children's Ages:*
    Please enter Children's Ages
  43. Number of Children Adopted:*
    Please enter Number of Children Adopted
  44. Other Information:
  45. Do you or your spouse have any major health concerns or history of health issues? (Ex. diabetes, cancer)*
    Please enter Family Health
  46. Have you or your spouse ever been treated for depression or mental illness?*
    Please enter Family Mental Illness
  47. Have you or your spouse had any arrests, charges and/or convictions of any criminal offense? (ex. DUI, trespassing)*
    Please enter Family Arrests
  48. Have you or your spouse ever been involved with illegal drug use?*
    Please enter any Family Drug Use
  49. Adoption Information:
  50. Have you had a home study done before?*
    Please select if you've had a Home Study
  51. If yes, date:
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  52. Homestudy Agency:
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  53. Agency Address
  54. Address 1:
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  55. Address 2:
    Invalid Input
  56. City:
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  57. State:
    Please select your state
  58. Zip:
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  59. Country:
    Please select your Country.
  60. Do you have any previous adoption experience? If yes, provide the date:*
    Please enter if you've had any Adoption Experience
  61. Have you ever experienced an unsuccessful adoption? If yes, please explain:*
    Please enter if you've had any Unsuccessful Adoptions
  62. Which Program are you interested in?*
    Please enter which Program you are interested in
  63. What type of child are you interested in adopting?*
    Please choose What Type of Child
  64. Age:
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  65. Siblings?
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  66. Waiting Child?
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  67. If you are interested in learning more about a specific child please enter child's name here:
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  68. Please share your reasons for adoption:*
    Please share your Reasons for Adoption
  69. Will your insurance cover the child upon arrival?*
    Please enter Insurance
  70. Will any pre-existing conditions be covered?*
    Please enter if Pre Existing Conditions are covered
  71. How did you hear about our agency?*
    Please enter how you Heard of Our Agency
  72. Other Comments?
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  73. Statement of Understanding By clicking on the "Agree/Submit" button below I/We signify that: To the best of my/our knowledge, the attached information is true.
  74. Enter Code:*
    Enter Code:
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Contact Us »

735 East HWY 56, P.0. Box W
Berthoud, CO 80513 (map)

Phone: (970) 532-3576

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