Holt International Children's Services -- Adult Adoptee Survey

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Since the mid 1950's Holt International has placed more than 40,000 children with adoptive families.

Although many of the adoptees have grown up-- what ever age they are-- it seems that adoptees never outgrow the pleasure of connecting with other adoptees who share the unique life experience of being an international adoptee.

For the first time, the Chair and Vice Chair of Holt's Board of Directors are adult adoptees. Their understanding and commitment to the adoptee experience is profound and deeply felt and acknowledged.

Holt is expanding our adult adoptee outreach program and would like to hear from adoptees to learn what would be of interest to them. Please take a moment to fill out the on-line questionnaire. We look forward to hearing from you.

For Adoptees 18 and Over

Your Current Information

First Name

Last Name

M.I.

Gender

Address

City

State

Country

Zip

Day Phone

Mobile:

Evening Phone

E-Mail

Occupation

Education

Marital Status

Married Single Divorced

Spouse's Name

Is your spouse adopted?

Yes No

If yes, what country ?

Do you have any children?

Yes No

If yes, how many?

Are any of your children adopted?

Yes No

If yes, from where?

Your Adoption Information

Birth Name

DOB

Country of Birth

Arrival Date

Arrival Country

Your Birth Search

Have you utilized Holt's background information service? (Please check all that apply)

Identifying Information Passive Voluntary Adoption Registry	Non-identifying information Assisted Search
Send Me Information About Holt's Adoptee Background Information Services

Is searching for your birth family an important issue for you?

Important Somewhat Not Important Not At This Time Not Sure

Reasons for search:

Medical Curiosity Other

Comments:

Do your parents know you're searching? Yes No

Are they supportive? Yes No

Have you searched before? Yes No

If yes, what process did you utilize? Please check all that apply.

U.S. Adoption Agency	Overseas Adoption Agency
Media	Internet
Private Agency	Contact in Country of Birth

Comments:

Did you locate your birth family? Yes No

Have you met your birth family? Yes No

If yes, do you have an ongoing relationship? Yes No

Comments:

Would you like to be in contact with other adoptees who have searched? Yes No

Other Information

Have you ever traveled to your birth country? Yes No

Have you participated in Holt Heritage Camp? Years:

Camper

Years

Counselor

Years

Motherland Tours / Year	Korean Gatherings/ Year
Mini Gatherings/ Year	Vietnam Reunion/ Year
Other Activities/Events/ Year

Adoptee Outreach

How can Holt best serve adult adoptees?

Adoptee-adoption conferences / workshops	Mentorship Opportunities
Adoption Articles, Books, Newsletters	Adult Adoptee Tours/ Retreats
Adoptee Chat Rooms, Bulletin Boards, Internet Sites	Education / Information on Issues of Race, Adoption & Ethnicity
Regional Events (Cultural-Adoption Related)	Networking with other Adoptees
Research on Adoption / Adoptee Experiences	Assistance with Birth Search
Not Sure

Do you currently participant in an adoptee group? Yes No

If yes, which group?

Comments:

Other Services

I would like to receive Holt's Enewsletter: Yes No

I would like to be added to Holt's E-mail information update list: Yes No

I would like to receive a complimentary copy of Holt's Holt International magazine: Yes No

I would like to attend Adult Adoptee events in my area: Yes No

I would like information about the 2008 Adult Adoptee tour in Korea: Yes No

I am interested in Volunteer Opportunities: Yes No

How did you find out about this survey?

Other

Feel free to send this survey to other adult adoptees or provide us with their names and contact information and we will contact them.

Thank you very much for taking part in this survey. The information you submit will be kept confidential.