接受特殊需要兒童意向書(shū)???
LETTER OF INTENT TO ADOPT SPECIAL NEED
CHILD?????????????
接受特殊需要兒童意向書(shū)
LETTER OF INTENT TO ADOPT SPECIAL NEED CHILD
兒童姓名:
Child's Name
|
性別:
Sex
|
出生日期:
DOB
|
所在福利院:
From:
|
兒童健康狀況:
Health Status of Child:
|
對(duì)收養(yǎng)父母的要求:
Requirements for the Adoptive Parents
|
醫(yī)療康復(fù)及撫育計(jì)劃:
Rehabilitation and Nurture Plan for the Child
收養(yǎng)人意見(jiàn):
Decision of Adopter:
收養(yǎng)人簽名:
Signature of Adoptive Father:
????????????????????????????????
簽名日期:
Signature of Adoptive Mother:
????????????????????????????????
Date:
|
委托組織:???????????????????????????????
制表日期:
Authorized
organization:????????????
Date of sending this form:
(China-ccaa.org October 16, 2006)