Family Pre-App
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Prospective Mother Information
First Name
*
Last Name
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Wife Email
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Wife Cell Phone
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Enter International
Date of Birth
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Race
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African American
Asian
Bi-racial
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Burkina Faso
Burundi
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Cameroon
Canada
Cape Verde
Cayman Islands
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Chad
Chile
China
Christmas Island
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Colombia
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Congo, Republic of the
Congo, The Democratic Republic Of The
Cook Islands
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Gabon
Gambia
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Germany
Ghana
Gibraltar
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Greenland
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Guadeloupe
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Guinea
Guinea-Bissau
Guyana
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Moldova
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Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territory
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russia
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Saint-Pierre and Miquelon
Samoa
San Marino
Sao Tomé and Príncipe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
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Canada
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Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo, Republic of the
Congo, The Democratic Republic Of The
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
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Hungary
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India
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Iran
Iraq
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Israel
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Japan
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Lao People's Democratic Republic
Latvia
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Liberia
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Liechtenstein
Lithuania
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Malawi
Malaysia
Maldives
Mali
Malta
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Mayotte
Mexico
Micronesia, Federated States of
Moldova
Monaco
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Montserrat
Morocco
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Myanmar
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Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territory
Panama
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Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
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Qatar
Réunion
Romania
Russia
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Saint Helena
Saint Kitts and Nevis
Saint Lucia
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Saint-Pierre and Miquelon
Samoa
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Solomon Islands
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Sudan
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Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
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Do you currently reside outside of the United States?
*
Yes
No
If married, Date of Marriage
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What church do you attend?
*
How did you first hear about Lifeline?
*
Church/Pastor
Friend
Lifeline Adoptive Family
Social Media
Web Search
Website
Other
Have you previously adopted or fostered through Lifeline?
*
Yes
No
Are you currently with another agency, interested in transferring to Lifeline?
*
Yes
No
Program(s) of Interest
Domestic Programs
**
Domestic Adoption
Domestic Adoption Special Needs
Home Study Only
Foster Care Programs
**
Adoption from Foster Care (South Dakota and Wyoming only)
Foster Care (Alabama, South Carolina, and Washington only)
International Programs
**
Brazil
Bulgaria
China
Colombia
Costa Rica
Dominican Republic
Haiti
Home Study Only
Honduras
Hong Kong
Hungary
India
Kyrgyzstan
North Macedonia
Peru
Philippines
Poland
Post Only
Romania
Taiwan
Ukraine
Hosting Programs
**
Colombia
Hosting (General Interest)
Philippines
Statement of Faith
Lifeline Children’s Services
Statement of Faith & Partnership Acknowledgment
God (Father, Son, and Holy Spirit)
We believe in God, eternally existing in three Persons: Father, Son, and Holy Spirit. (Matthew 3:16-17; Matthew 28:19; John 1:1-51; John 10:30)
We believe that Jesus Christ is the one and only begotten Son of God, conceived by the Holy Spirit, born of the virgin Mary and is fully God and fully man. (Mark 14:61; Luke 3:22; John 8:58; Colossians 2:8-9; Philippians 2:5-11)
We believe in the physical resurrection of the crucified body of our Lord, in His ascension into Heaven, and His present life there for us as our High Priest and Advocate providing a sufficiency for body, soul, and spirit for the believers. (Acts 3:15; 1 Corinthians 15:12-32; Hebrews 4:14-16)
Salvation & The Work of Christ
We believe that the Lord Jesus Christ died for our sins according to the Scriptures as a representative, substitutionary, and complete sacrifice; and that all who believe in Him are justified on the ground of His shed blood. (Isaiah 53:46; 2 Corinthians 5:17-21; Ephesians 5:1-2; 1 Peter 2:24, 3:18)
We believe that all who receive by grace, through faith, the Lord Jesus Christ are born of the Holy Spirit and become children of God, and there is no other way of salvation but through Jesus. (John 1:12-14, 3:3, 5:24, 14:6; Galatians 4:4-7; Ephesians 2:8-10)
We believe in the personal, visible, and second coming of our Lord Jesus Christ, at a time unknown to us but for which we are eagerly anticipating. (Matthew 24:42-44; John 14:1-3; I Thessalonians 4:16-17; Hebrews 9:28; 2 Peter 3:10)
We believe that the redeemed will have eternal life with Christ Jesus while the lost will be separated from God in everlasting punishment. (Matthew 25:31-46; Acts 17:30-32; 1 Corinthians 15:52; 1 Thessalonians 4:16)
We believe that every believer is sanctified through the work of the Holy Spirit to pursue personal holiness. (1 Thessalonians 4:3-9; 1 Peter 15-16; 1 Corinthians 6:9-13; Ephesians 5:4-5)
Humanity
We believe that man was created in the image of God; that he sinned and incurred not only physical death, but also spiritual death which is separation from God; and that all human beings are born with a sinful nature, and become sinners in thought, word, and deed. (Genesis 1:26-27, 8:21; Psalm 51:5; Ecclesiastes 7:20; Colossians 3:6-10; Ephesians 2:2-3)
We believe that marriage is a sacred covenant before God and man between one man and one woman instituted by God from the beginning of Creation. (Genesis 2:18-24; Matthew 19:4-6; 1 Corinthians 7:1-16; Hebrews 13:4-7)
We believe that God is the creator of all life, and that every person is created in His image, and at the moment of conception, a new human life is created with a sovereignly-ordained sex of either male or female. (Genesis 1:27; Psalm 139:13-16; Jeremiah 1:5; Acts 17:25)
The Word of God
We believe the Scriptures of the Old and New Testament to be the Word of God, written by men under the inspiration of the Holy Spirit. The Word is inerrant, infallible, and sufficient in all manners of conduct. (Deuteronomy 6:4-6; Proverbs 30:5-6; 2 Timothy 3:15-17; 1 Peter 1:23-25)
The Work of Church
We believe that the Great Commission was given by the Lord to His church to disciple the world, and that sharing the Gospel is the great mission of the Church. (Matthew 28:16-20; Mark 16:15; John 20:21; Acts 1:8)
As a ministry, Lifeline Children’s Services committed to Gospel-centered service to our clients: vulnerable children, women and men experiencing crisis pregnancies, and broken families in need of restoration. My affirmation of these doctrines represents a basis for ministry collaboration with Lifeline as an adoptive family, and my acknowledgement that through adoption I am becoming a ministry partner with Lifeline.
Agree to Faith Statement
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Prospective Father Signature
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Signature Date
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Prospective Mother Signature
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Signature Date
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