JFS 01654 - Adoptive Placement Agreement

Child Name

Select the name of the child who is being placed in an adoptive home.  This is a required field.

Supervising Agency

Enter the name of the supervising agency if it is different from the custodial agency.

Contact Phone Number

Enter the phone number the adoptive parents should use to contact the agency. This number should be appropriate for reporting emergencies as well as for normal communication.

Describe additional financial assistance provided by agency

If the agency will provide the family with financial assistance during the placement, briefly describe the assistance.