Become a member of New Roots!

New Roots meetings and resources are open to all, but we depend on a supportive base of member families to provide the financial support needed for New Roots to provide its services. Please consider joining New Roots! The annual membership for an individual or family of any size is only $30. Your modest membership contribution allows New Roots to maintain and expand its range of resources and support opportunities!

To join New Roots, just print out the form below, fill it in, and submit with a check for $30 made out to New Roots to:

New Roots Membership
P.O. Box 14953
Columbus, OH 43214

New Roots Membership Application

YES! I would like to join New Roots / renew my membership to help the organization continue its services!

Name of Adult member(s):

Street Address:

City, State, Zip:

Today's date:

Home Phone (do not provide if unlisted):

E-mail address:

______ Enclosed is $30 for a basic New Roots membership for our family.

______ Enclosed is a check for $_________ to cover our family's membership plus a donation to assist with the organization's future development.

Family information: This information will remain confidential upon request. It is used to assist other adoptive families. Please include information on biological and adopted children, and the current stage of your adoption process if applicable.

______ Check here to keep the following information confidential.

• Our stage in the adoption process
  
  ______ Just beginning
  
  ______ Actively in the adoption process
  
  ______Have adopted, and plan to adopt again
  
  ______Have adopted and are not planning to adopt again
  
  ______Other:
  
  
• If you have children, how many? ______
  If you have children, please complete the following on each child, and duplicate this form if necessary:
  
  
• Child #1:Full name:
  
  Birth date:
  
  Sex: M F Adopted: Y N
  
  Child's country or state of origin:
  
  Type of adoption (private, agency, etc.):
  
  Agency or attorney's name, city and state:
  
  
• Child #2:Full name:
  
  Birth date:
  
  Sex: M F Adopted: Y N
  
  Child's country or state of origin:
  
  Type of adoption (private, agency, etc.):
  
  Agency or attorney's name, city and state:
  
  
  
  New Roots
  Adoptive Families Support Group
  P.O. Box 14953
  Columbus, Ohio 43214
  newroots1@yahoo.com
  
  

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