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REUNION REGISTRY
SEARCH FORM
The Texas Reunion Registry has been officially taken over by Linda Strength. She has been in the adoption arena for many years and has assisted countless adoptees and birth parents in reuniting. Modify this form to fit your needs (for instance if you are a birth parent or birth sibling, etc.). Fill out this form as best you can and send it back to me at:
Linda Strength
P.O. Box 8445 Bacliff, TX 77518
Phone: 281-339-1129
Fax: 603-853-2742
Email: srchgrl@wt.net
Your name:________________________
Address:__________________________
Telephone Number:__________________
Other Contact Information:___________________________
Email contact:___________________________
Seeking:________________________________
Sex:____________________________________
DOB:____________________________________
City/County/State of Birth:__________________________
Hospital of Birth:__________________________________
Attending Doctor:___________________________
Birth name if known:_________________________
Birth certificate# State:_______________________
Adoptive name:_____________________________
Adoptive parents name(s):____________________
Date of adoption or relinquishment:_____________
County/State adoption or relinquishment was finalized in:__________________________
Childs age at adoption or relinquishment:________
Child Placing Agency/individual:_______________
Place of adoption or relinquishment:___________
Court of adoption or relinquishment: ________________________________________
Decree of Adoption case#: _______________________________________
Birth Mother's information
Name at birth:_____________________________
Current name:____________________________
Maiden name:_____________________________
Nick name:________________________________
Age at birth:_______________________________
Ethnic heritage:____________________________
DOB:____________________________________
Place of birth:______________________________
Occupation:_______________________________
Last know address:_________________________
Where is Birth Mother:______________________
Birth Parents married/when/where:____________
Siblings:__________________________________
Birth Father's information
Name:___________________________________
Nick name:________________________________
Age at birth:_______________________________
Ethnic heritage:____________________________
DOB:___________________________________
Place of birth:_____________________________
Occupation:______________________________
Last know address:_________________________
Where is Birth Father:______________________
Nonidentifying Information:
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Your comments:
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