PSA'S

Home Study Checklist:

• Application
• Release of Information
• Adoption Information Form
• CSS Birthparent/Child Medical Expenses Form
• Three personal references
• One pastoral reference
• One financial reference
• Marriage Certificate
• Birth Certificate
• Medical forms for each applicant
• Background check for child abuse/neglect
• Background check for outstanding child support
• Background check for criminal history
• 1040 Income Tax form
• Statement of Net Worth
• Water test (If not community)
• Autobiographies for all applicants
• Interview process (Individual, Joint and home visit)
• Profile Book
• Adoption Workshop

United Way of the Black Hills