Registry Form

This registry is for adoptee's whose adoption's were known to be illegal and birth records falsified.
 If yours was a legal adoption please register with other registries.
 Please note: All personal information submitted is strictly confidential. The only information posted will be: DOB, Male/Female, City of birth, Birth State, Delivering Dr.
All other information is for identification purposes and will be maintained in a database off-line.
*Include as much information as you have


 
Black Market Adoptee's Registry
Fields marked with * are REQUIRED.
If the required fields are not filled in
your registration will not appear on this website. 
The person filling this out is the registrant.

 * Registrants Full Name

* Registrant is:

 * Your Street Address

* Your City, 

* Your State and Zip 

* Home Phone # (include area code) 

FAX Phone # (include area code)

* E-mail address PLEASE fill it in correctly

URL of website if you have one

* Registrant is searching for 

* Adoptee's Date of Birth or as close as possible

Adoptee gender ?

 Hospital of Birth

* City and State of Birth 

Name of Physician

Birth Certificate Number

Birth name if known

Birth Mom's name if known

Birth Mom's DOB if known
or her age when adoptee was born

Adoption Type

Name of Adoption Agency

this is a 

 Post on Internet?

*What leads you to believe your adoption was illegal?
Include any additional information that you have.


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 July 22, 2003
last updated


        Black Market Adoptee's Registry 


 

Registry Owner
S. Durham
E-mail:Prairiebaby



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Updated
10/12/00

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