To__________Adoption Organization,
Through the
examination of the basic condition of the adoptive families and
their plan of treatment and rehabilitation for the child
____________from____________welfare institute, it is agreed that
the adoption will be carried out through the procedure for adopting
children of special needs after the submission of application
documents of the adopters according to their wish.
(Sealed) Administration Department,
China
Center of Adoption Affairs
Month
Day
Year
(China-ccaa.org October 16, 2006)