LOS SANTOS CITY GOVERNMENT
DEPARTMENT OF HEALTH AND HUMAN SERVICES
CARCER WAY 1, ROCKFORD HILLS, LOS SANTOS, SA
DEPARTMENT OF HEALTH AND HUMAN SERVICES
CARCER WAY 1, ROCKFORD HILLS, LOS SANTOS, SA
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Adoption & Foster Care Inquiry
DEPARTMENT OF HEALTH & WELFARE - AS PREPARED FOR PUBLICATION- Los Santos, SA ~ Friday, 29 of September 2023 |
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[center][img]https://i.imgur.com/fLoBoAF.png[/img][/center][br][/br][br][/br][divbox=transparent][center][b][size=250][color=#535a6c]Adoption & Foster Care Inquiry Form[/color][/size]
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[br][/br][color=#535a6c][size=150][b]Basic Information[/b][/size][/color][hr][/hr]
[list=none][*][b]1.1 Title: [/b] Mr./Mrs./Miss./Dr./Ms.
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[*][b]1.2 First name(s): [/b] Answer
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[*][b]1.3 Last name: [/b] Answer
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[b]1.4 Date of Birth: [/b] DD/MM/YYYY
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[b]1.5 Phone number: [/b] Answer
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[b]1.6 Email address: [/b] Answer
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[b]1.7 Place of Birth: [/b] Answer
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[b]1.8 Nationality: [/b] Answer
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[b]1.9 Residential address: [/b] # Street Name, City, State
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[br][/br][br][/br][accordionfixed=1;ACKNOWLEDGEMENT & AUTHORIZATION]
[br][/br][justify]By submitting this application, I, Full Name, hereby certify that all the questions contained in this document were met with truthful statements. I fully authorize the investigation of any content shared on this document. I am aware that lying, omitting, plagiarizing, or maliciously adulterating this application will result in immediate denial and an indefinite ban from applying for future programs and initiatives.[/justify]
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