Adoption Loan Application Row concave-2 Shape Decorative svg added to top "*" indicates required fields Step 1 of 8 12% Adopting Father’s Full Name* First Last Adopting Mother’s Full Name* First Last Home Address (Mailing Address)* Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Primary Contact:* Father Mother Single Parent:* Yes No Adopting FatherPhone*Email* Untitled*Date* MM slash DD slash YYYY Driver’s License No.*Adopting Father’s Occupation*Employer*Employer Address* Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Length of Employment*Monthly Net Salary $*Previous Employer*Previous Employer*Adopting MotherPhone*Email* Untitled*Date* MM slash DD slash YYYY Driver’s License No.*Adopting Mother's Occupation*Employer*Employer Address* Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Length of Employment*Monthly Net Salary $*Previous Employer*Previous Employer*Years You Have Been Married*Name and Age of Children in the Home*Child NameChild Age Add RemoveHave you adopted before?* Yes No please provide details* Adoption Journey & Faith StatementAdoption Agency*If you are working with a consultant, please list all agencies you have signed with. Adoption Consultant*Adoption Consultant Address* Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Name of contact or social worker* Name of contact or social worker Phone*Type of Adoption:* Intercountry Domestic How many children are you adopting?*Sibling Set?* Yes No Children Adopted*NameAgeGenderCountry/Location Add RemoveHave you completed process to receive travel approval to pick up the child?* Yes No Travel Date*Have you already been matched?* Yes No Birthmother’s Due Date or Placement Date*Are you planning to adopt a child with special needs?* Yes No Any other important details about your adoption?*We’d like to get to know your faith background and how the Lord has brought you to adoption!Church Name*Location*Denomination*Does your church have an adoption ministry?* Yes No Please provide contact details*Please submit a letter of recommendation from a Pastor at your church* Drop files here or Select files Max. file size: 2 GB. Adopting Father Testimony:*Please share about your faith journey, major milestones in your faith and what led you to be where you are in your faith today. Adopting Mother Testimony:*Please share about your faith journey, major milestones in your faith and what led you to be where you are in your faith today. Statement of Faith: WE BELIEVE the Bible to be the inspired, the only infallible, authoritative Word of God. WE BELIEVE that there is one God, eternally existent in three persons: Father, Son and Holy Spirit. WE BELIEVE in the deity and humanity of Christ, in His virgin birth, in His sinless life, in His miracles, in His vicarious and atoning death through His shed blood, in His bodily resurrection, in His ascension to the right hand of the Father, in His present rule as Head of the Church and in His personal return in power and glory. WE BELIEVE that, for the salvation of lost and sinful man, repentance of sin and faith in Jesus Christ results in regeneration by the Holy Spirit and that Jesus Christ is the only way of salvation. WE BELIEVE in the present ministry of the Holy Spirit, by whose indwelling the Christian is enabled to live a godly life. WE BELIEVE in the resurrection of both the saved and the lost, they that are saved unto the resurrection of life and they that are lost unto the resurrection of damnation. WE BELIEVE in the spiritual unity of believers in our Lord Jesus Christ, with equality across racial, gender, and class differences. 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. As a family, we share this statement of faith* As a family, we share this statement of faith What role does the Word of God have in your daily life?*How has your Christian faith impacted your decision to adopt?*What are your family’s Christian core values?* Adoption FinancialsAmount of financial assistance requested, up to $10,000.00 (interest-free loan)*Would you be able to complete your adoption without assistance from Pathways for Little Feet?* Yes No If approved, what amount could you agree to repay each month until full reimbursement is made?*(*This is not binding. After review, we may request your consideration of a different monthly payment amount.) Adoption CostsHome Study and Related Fees*Total Agency Fees*Consultant Fees*Travel Expenses*Other:* Add RemoveTotal Anticipated Adoption Costs*Please upload your current anticipated cost document provided by your attorney, consultant, agency, or other provider.* Drop files here or Select files Accepted file types: jpg, png, pdf, Max. file size: 2 GB. Source of FundsPersonal Funds (savings, etc.)*Employer Assistance*Fundraising*Grant/Loan*Grant/Loan:$Applied or awarded? Add RemovePlease list each granting organization individuallyOther:* Add RemoveTotal Estimated Resources* Statement of Net WorthAssetsCash*Checking*Savings*Investments:Stocks*Bonds*Real Estate (other than your home)*Retirement Accounts*Value of Home (if owned)*Value of Autos*Household*Other:* Add RemoveTotal Assets*LiabilitiesOutstanding Credit Card Balances*Student Loans*Home Mortgage Balance*Auto Loan Balance*Any Other Bills/Amounts Owed:*Bills/Amounts Owed$ Add RemoveTotal Liabilities*Total Net Worth (Assets – Liabilities)* Cash FlowIncome (Please note net income is after taxes, 401K, healthcare and other witholdings)Monthly Net Salary/Wage*Other Monthly Income:* Add RemoveTotal Net Income*Expenses & PaymentsChurch/Charitable Giving (Tithe)*Debt Repayment (not including mortgage)* Housing: Mortgage/Rent*Property Taxes*Home/Rental Insurance*Utilities*Other*Other$ Add RemovePhone/Internet*Groceries/Food*Transportation: Car Payment*Car Insurance*Gas/Maintenance*Other*Other$ Add RemoveEntertainment/Recreation*Medical Expenses*Child Care*Other*Misc./Other$ Add RemoveTotal Expenses*Cash Flow (Income – Expenses)* Consent FormBy signing this form and submitting this application: Please read closely and respond accordingly We hereby give consent for Pathways for Little Feet to contact our adoption agency and any other person or institution named in this application and we authorize such persons and institutions to release information to Pathways for Little Feet. It is our understanding that information obtained will be used, in part, to determine our eligibility for a loan. We also understand and agree that Pathways for Little Feet is not obligated to provide financial assistance based on the willingness to accept an application. We understand, if approved for an interest-free loan, that our agreement would be in the form of a covenant with Pathways for Little Feet. This covenant agreement includes the approval of an auto-draft authorization for monthly repayments of the loan, beginning two months after the funds are released to the adoptive parents. Once the adoption is complete, we give Pathways for Little Feet permission to use our story and/or photographs in their communications and/or marketing material, with the purpose of advocating for adoption and helping more families adopt. We understand that Pathways for Little Feet will protect our family and child's identify by utilizing a false name or letter to represent our story. If approved for an interest-free loan, we agree to share our adoption story, be interviewed by Pathways for Little Feet, and/or provide pictures and updates with the purpose of advocating for adoption and helping more families adopt. If approved for an interest-free loan, we agree to share our adoption story, be interviewed by Pathways for Little Feet, and/or provide pictures and updates with the purpose of advocating for adoption and helping more families adopt.* Yes No *If no, please explain*Signature of Adopting Father (Print)* First Last Date* MM slash DD slash YYYY Signature of Adopting Mother (Print)* First Last Date* MM slash DD slash YYYY References & Application ChecklistReferences:Name* First Last Phone*Email* Relation*Name* First Last Phone*Email* Relation*Name* First Last Phone*Email* Relation*Please upload your 3 personal or character references. These can be references you utilized for your Home Study or Adoption Agency.* Drop files here or Select files Max. file size: 2 GB. How did you hear about Pathways for Little Feet?* Submitting Application & Checklist:Please submit the following information for both parents as applicable:Full Approved Original Home Study & Any Updates* Drop files here or Select files Max. file size: 2 GB. Current Credit Score and Report for Both Parents* Drop files here or Select files Max. file size: 2 GB. Please upload the full credit report that includes your credit score, credit history and has your name on the fileMost Current Year’s Tax Information* Drop files here or Select files Max. file size: 2 GB. Last Month’s Bank Statements (Checking & Savings)* Drop files here or Select files Max. file size: 2 GB. Please include all accountsCopy of Both Parents Valid Driver’s License* Drop files here or Select files Max. file size: 2 GB. Copy of Last Two Pay Stubs per Individual* Drop files here or Select files Max. file size: 2 GB. Letter of Recommendation from a Pastor at Your Church* Drop files here or Select files Max. file size: 2 GB. This can be your small group leader or pastor at your church who knows your family bestCAPTCHA Δ
