Become a CHASK family, or Update your profile CHASK Adoption Application Please take your time filling out your application. It is important for birth parents to read about potential families for the children they are placing — keep in mind this is the first time they will have the opportunity to imagine what their child's life might be like with you and your family. Don't be afraid to describe your home life, your children, your hobbies and interests. If you are hesitant and would like more time, simply review some of the current CHASK family profiles we have in our Waiting Families portion of our site to get some ideas about how you might like to write about your family. Thank you for your support in this ministry! CHASK Adoption Application, please choose one of the following options: * I am a CHASK Family — I need to update/revise my family's profile I am not a CHASK Family — I need to submit an application First Name * Please include spouse's name if you are married. Thank you! Last Name * Mailing Address * City * State * Zip Code * Email * Website/Blog Site Phone * Cell Phone Marital Status * Married Single parent *If married, must include spouse's name in order to complete the adoption application process. Thank you! How old are you (and your spouse if applicable)? * 18-25 26-35 36-40 41-45 46-55 56 or older Current Homestudy * Yes No In the process Our family is open to: * Adoption Disruption Guardianship Guardianship — 11-years-and-older with moderate-severe special needs Respite — Under 10-years old Respite — 11-years-and-older All the above Age(s) of child you would prefer: * 0-2 years 2-4 years 4-6 years 6-8 years 9-older with moderate to severe special needs Our family is open to children that are: * Caucasian African American/Black Native American Bi-racial Asian American Hispanic/Latin All the above Able to care for children with special needs: * Mild Moderate Severe Total care Please choose at least one of the following options Are you interested in sibling groups? * Yes Sorry, No Maybe Do you have children? * Yes No How many children do you have? * If you have no children, please enter 0 How many of your children are biological? How many of your children are adopted? Do any of your children have special needs? If so, please list them below. Describe briefly your family, including children or anyone else living in the home. * You must complete this portion of the application in order for your application to be processed. Thank you! What are your reasons for wanting to adopt a special needs child? * You must complete this portion of the application in order for your application to be processed. Thank you! Describe Your Faith In Christ. * You must complete this portion of the application in order for your application to be processed. Thank you! Church your family attends regularly: * *This information is private and used for our records only, it is not included in your CHASK Adopting Profile. Pastor/Priest's name: * *This information is private and used for our records only, it is not included in your CHASK Adopting Profile. Pastor/Priest's phone * *This information is private and used for our records only, it is not included in your CHASK Adopting Profile. Reference 1: First, Last name * *This information is private and used for our records only, it is not included in your CHASK Adopting Profile. Phone * Reference 2: First, Last name * *This information is private and used for our records only, it is not included in your CHASK Adopting Profile. Phone * Our family is willing to offer support/counsel to: * Birth-Mom considering abortion/or had an abortion Birth-Moms/Parents considering placing their child, yet are undecided Parent(s) who are considering disruption/respite Other parents of special-needs children All the above No thank you, not at this time Dear Birth Mom/Parents: * Please see our Waiting Families page to view "Dear Birth Mom/Parent" letters to use as examples. If this area is not completed, your application will not be processed. Thank you! Would you like your family's profile to appear on the CHASK site "Waiting Families" page? * Yes No thank you, not at this time Maybe, I have some questions Current picture of your family Uploading Files. Please Wait. Photo must be gif, png or jpg format. If you do not have a picture handy, you may e-mail one later. However, your application will not be complete until we have received a current photo to include with your CHASK profile. Thank you! Please verify that you have fully read and are in agreement with our Statement of Faith. If not, please see below. * Yes Please enter the two words below in the box provided: If you have not had the opportunity to review our Statement of Faith, you may do so here. This link will open in another tab or window on your computer, you will not lose the information you have entered on this form.