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WAT! Adoption Grant Application

PLEASE READ WAT! ADOPTION GRANT APPLICATION INSTRUCTIONS (CLICK HERE) BEFORE CONTINUING WITH ONLINE APPLICATION. TO DOWNLOAD APPLICATION, CLICK HERE.

How did you hear about WAT!?*
Basic Information
First Applicant Name (First, Middle, Last)*
First Applicant Date of Birth*
MM slash DD slash YYYY
First Applicant Gender*
- Female
- Male
- Prefer not to say
- Other
Mark only one oval.
First Applicant Address*
First Applicant Email Address*
First Applicant Phone Number*
First Applicant Employment Status*
- Full Time
- Part Time
- Self-Employed
- Unemployed
- Student
- Homemaker
- Retired
- Other
First Applicant Ethnicity (check all that apply)*
- Black
- Asian
- White
- Native American
- Latinx
- Other
Check all that apply.
Second Applicant Name*
Second Applicant Date of Birth*
MM slash DD slash YYYY
Second Applicant Gender*
- Female
- Male
- Prefer not to say
- Other
Mark only one oval.
Second Applicant Address*
Second Applicant Email Address*
Second Applicant Phone Number*
Second Applicant Employment Status*
- Full Time
- Part Time
- Self-Employed
- Unemployed
- Student
- Homemaker
- Retired
- Other
Mark only one oval.
Second Applicant Ethnicity (check all that apply)*
- Black
- Asian
- White
- Native American
- Latinx
- Other
Check all that apply.
Relation to first applicant*
Family Information
Do you have children? If yes, how many? Please include names, ages, and indicate whether they joined your family by birth, adoption, foster care, etc.*
How many children currently live in your home?*
If you are currently fostering any children, how many?*
Have you previously adopted? If so, when and through what agency?*
Does anyone outside of your immediate family currently live in your home? Please give details.*
Financials
What is your projected household income for this year? Please include all sources of income.*
What is your current savings account(s) balance?*
What is your current checking account(s) balance?*
What is your net monthly income (household)?*
What is your mortgage/rent amount per month?*
What is your auto loan amount per month?*
What is your student loan payment per month?*
What is your total credit card payment per month?*
What other debt do you have per month (type and amount*
Have you raised any funds toward your adoption expenses? If so, what have you done and how much have you raised?*
Have you received any other adoption grants or loans? If so, through whom and how much?*
Adoption Plan
What type of adoption are you pursuing?*
- Private domestic
- International
- Foster-to-Adopt
- Family Placement
- Other
Mark only one oval.
Have you been matched with or placed with a child for adoption?*
- Yes
- No
Mark only one oval.
How is your adoption being facilitated?*
- Agency
- Attorney
- Other
Mark only one oval.
Agency/Attorney Contact Name*
Agency/Attorney Address*
Primary contact at agency/attorney's office*
Contact phone*
Contact Email*
Personal Statement
Why are you seeking to adopt? Tell us your story.*
Certification
I/we [applicant(s)] have answered all questions completely and truthfully to the best of our knowledge. I/we have submitted/ will submit the supplemental materials completely and truthfully and understand application will not be considered complete until all supplemental materials are submitted. I/we give all adoption professionals working on our adoption (adoption agency, adoption attorney, and any other adoption professionals) permission to share any information pertinent to the award of the WAT! Adoption Grant with WAT! I/ we will contact WAT! immediately if it becomes known after submission that any information provided in the application and or supplemental materials was incomplete and or inaccurate. **
- I/We Agree.
- I/We Do Not Agree.
Mark only one oval.

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