Promise686 Adop
tion Grant Pre-Approval Application
Select the type of grant you are seeking:
Please select...
Adoption Matching Grant
Legal Also (For Adoption Matching Grant recipients)
Legal Only (For help with finalization fees after child has arrived)
Post-Placement Support
First Name of Primary Contact
Last Name of Primary Contact
Street Address
City
State (2-letter code)
Zipcode
County
Please select...
Barrow
Bartow
Cherokee
Clayton
Cobb
Coweta
Dekalb
Douglas
Fayette
Forsyth
Fulton
Gwinnett
Hall
Henry
Newton
Paulding
Rockdale
Spalding
Walton
Other
Email Address
Home Telephone
Mobile Telephone
Husband's First and Last Name
Wife's First Name
Wife's Last Name
Are you a member in good standing with a local church?
Please select...
No
Yes
I have completed my Home Study
Please select...
No
Yes
Page 2 -
Promise686 Adop
tion Grant Pre-Approval Application
Church Information
Church Name
Church Street Address
City
State (2-letter code)
Zipcode
Church Denomination
Church Contact
(Pastor, Staff Member, or Officer [Elder or Deacon] who will provide a reference:
First Name of Church Reference
Last Name of Church Reference:
Telephone Number
Email
Do you profess Jesus Christ as your personal Lord and Savior?
No
Yes
Does your church have an orphan-care ministry?
No
Yes
Page 3 -
Promise686 Adop
tion Grant Pre-Approval Application
Adoption Agency Information
Adoption Agency
Adoption Placement Agency Name
Agency Street Address
Agency City
Agency State (2-letter code)
Agency Zipcode
Agency Phone
Is this agency an official 501(c)(3) placement agency?
No
Yes
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Contact Information