接受特殊需要儿童意向书
LETTER OF INTENT TO ADOPT SPECIAL NEED
CHILD
接受特殊需要儿童意向书
LETTER OF INTENT TO ADOPT SPECIAL NEED CHILD
儿童姓名:
Child's Name
|
性别:
Sex
|
出生日期:
DOB
|
所在福利院:
From:
|
儿童健康状况:
Health Status of Child:
|
对收养父母的要求:
Requirements for the Adoptive Parents
|
医疗康复及抚育计划:
Rehabilitation and Nurture Plan for the Child
收养人意见:
Decision of Adopter:
收养人签名:
Signature of Adoptive Father:
签名日期:
Signature of Adoptive Mother:
Date:
|
委托组织:
制表日期:
Authorized
organization:
Date of sending this form:
(China-ccaa.org October 16, 2006)