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Adult Adopted Person Forms - The Cradle

Adult Adopted Person Forms - The Cradle

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Fee Schedule<br />

Post Adoption Services<br />

Your Full Name (please print): ___________________________________________________ Date: ________________<br />

Requested Service(s)<br />

Non-Identifying Information<br />

Registry<br />

Background History Report (DOB 1923-1940) $50<br />

Fees<br />

Background History Report (DOB 1941-present) $125<br />

Brief Update (if you have previously received background information) $50<br />

File Check $25<br />

Birth Parent Report (for Birth Parents only) $0<br />

Registry OR $40<br />

Registry with Illinois Adoption Registry Medical Questionnaire $0<br />

Reaching Out<br />

Basic Search $225<br />

Extended Search (if Basic Search is unsuccessful) $300<br />

Reconnection $50<br />

2049 Ridge Avenue, Evanston, IL 60201 847-475-5800<br />

Counseling/Consultation<br />

In person<br />

By phone<br />

Mediation at <strong>The</strong> <strong>Cradle</strong><br />

Community Services<br />

Training<br />

$110 (per hour)<br />

$110 (per hour)<br />

(Prorated by 1/2 hour)<br />

$110 (per hour)<br />

contact us for more information<br />

Total Fees: __________<br />

Contribution: __________<br />

Payment Method Total Payment: __________<br />

Check made out to <strong>The</strong> <strong>Cradle</strong> enclosed<br />

If paying by credit card:<br />

Name on Card:<br />

Visa Card Number:<br />

MasterCard Expiration Date:<br />

Discover 3-digit Security Code on back of card ___________________________<br />

Signature:<br />

Current Address: __________________________________________<br />

__________________________________________<br />

FEES SUBJECT TO CHANGE WITHOUT NOTICE!<br />

For Office Use Only:<br />

Date Received: ______________________________<br />

Payment Received: _________________<br />

09/09 x:/Materials/Post Adoption/<strong>Forms</strong>/Fee Schedule.doc

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