Apply to adoptThe information you provide on the form will be processed in line with our data protection policy.Please answer the questions below so that we can gain an understanding of your circumstances. All information we receive will be treated in the strictest confidence and will not be disclosed to third parties.We look forward to hearing from you soon.Your detailsYour nameFirst nameLast nameDate of birthGenderMaleFemaleWhat is your religion?No religionChristian (including Church of England, Catholic, Protestant and all other Christian denominations)BuddhistHinduJewishMuslimSikhAny other religion (please describe)Other religionWhich religion?EthnicityEthnicity- Select -White - English / Welsh / Scottish / Northern Irish / BritishWhite - IrishWhite - Gypsy or Irish TravellerWhite - Any other White background (please describe)Mixed - White and Black CaribbeanMixed - White and Black AfricanMixed - White and AsianMixed - Any other Mixed / Multiple ethnic background (please describe)Asian / Asian British - IndianAsian / Asian British - PakistaniAsian / Asian British - BangladeshiAsian / Asian British - ChineseAsian / Asian British - Any other Asian background (please describe)Black / Black British - AfricanBlack / Black British - CaribbeanBlack / Black British - Any other Black / Black British background (please describe)Other ethnic group - ArabOther ethnic group - any other ethnic background (describe)Describe your ethnic group...Do you have children?YesNoHow long have you been in your current relationship?YearsMonthsContact detailsAddressAddress line 1Address line 2TownPostcodePhoneEmailHousehold detailsOther than yourself, how many people live in your property?Select01234567Other people living with youPerson 1Full nameGenderFemaleMaleDate of birthRelationship to youPerson 2Full nameGenderFemaleMaleDate of birthRelationship to youPerson 3Full nameGenderSelectMaleFemaleDate of birthRelationship to youPerson 4Full nameGenderSelectMaleFemaleDate of birthRelationship to youPerson 5Full nameGenderSelectMaleFemaleDate of birthRelationship to youPerson 6Full nameGenderSelectMaleFemaleDate of birthRelationship to youPerson 7Full name GenderSelectMaleFemaleDate of birthRelationship to youNumber of bedrooms in the propertyNumber of bedrooms in the propertyNumber of bedrooms in the propertySelect1234567891 bedroom council propertiesIf residing in a one bedroom council property at what stage will you be moving? How realistic is it that you will be given a larger property if residing in a council property, or when will you move if privately owned?General enquiresHave you made enquires to another agency?YesNoWhat was the outcome?Where did you hear about adoption and why are you considering it in Barking and Dagenham?What is the main reason for your enquiry?What age range are you considering?Would you like to adopt a single child or siblings?Relationships: Do you have any children from a previous relationship? What is the nature of this relationship with your child/ren? What is the nature of your relationship with your ex-partner?Criminal record: Have you ever been charged for a criminal offence or given a caution or reprimand?Do you smoke?Do you own any pets?YesNoWhat kind? By clicking the submit button, you agree to the information you provide on this form being processed in line with our data protection policy.