Appendix 5--Letter of Intent to Adopt Secial Needs Child
GOV.cn Wednesday, August 31, 2005

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:

 
Editor: Chen Feng
Source: China-ccaa.org