Autobiography Outline

Please complete this form for each adoptive applicant.

- Step 1 of 7

This information will be directly quoted on your home study, please be as descriptive as possible.

Personal Information

Your full name (including maiden name): *

Your parents full names (including mother’s maiden name): *

Your date of birth:

City of your birth:

State of your birth:

Height:

Weight:

Ethnicity:

Describe yourself using three adjectives.

Describe your favorite forms of recreation and hobbies.

How do you handle stress?

On whom do you rely for your own support system?

Describe your life goals.

Extended Family - Father

Current age:

If deceased, what age did he pass?

Current residence:

City/State

Current employment:

What was his employment when you were a child?

Describe your father, in terms of his personality when you were a child. How do you relate with him as an adult?

If passed, distant, or unknown please indicate:

Extended Family - Mother

Current age:

If deceased, what year did she pass away?

Current residence:

City/State

Current employment:

What was her employment when you were a child?

Describe your mother, in terms of her personality when you were a child. How do you relate with her as an adult?

If passed, distant, or unknown please indicate:

Childhood

Where were you raised?

What adjective would you use to describe your childhood?

What is your fondest childhood memory?

What was the best part of growing up (before graduating from high school)?

What was the worst part of growing up?

What was your family theme, values, what was most important in your family?

Please describe religious influences (if any) in the home while growing up, and what role did this influence play in your family?

Please describe adult religious influences and/or perspectives.

Which parent provided a majority of the discipline? What were the typical forms of discipline used?

Who handled the family finances?

If your parents divorced, please state the month/year of their divorce.

If your parents remarried or had previous marriages, please state the names of spouses and month/year of marriages.

Schools, teachers, studies

Where did you attend school? (Grade schools, jr. high, high school, college).

Please list extracurricular activities.

Month and year of graduation and name of school issuing diploma.

Work History

Please provide a basic overview of your work history.

Please name your current employer, your employment title and month/year employment began with your current employer.

Marital/Relationship

If single:

How do you feel about marriage?

How do you feel about a committed relationship?

How will adoption affect a future relationship?

If married:

Date and location of marriage:

How did you and your spouse meet?

How long did you date before marrying?

What attracted you to each other?

How would you describe your spouse?

What are the marriage strengths and areas of weakness?

Describe how you communicate in your relationship?

Describe what problems arise most often in your relationship?

How do you resolve conflict/disagreements?

What do you do as a family?

If previously divorced:

Please list month/year of marriage:

What is the name of your former spouse?

Please list month/year of divorce:

Please describe the events leading up to the dissolution of that marriage:

What have you learned from your previous marriage and what are you doing differently?

Names and dates of birth for children born from this marriage.

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