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Registry Submission Form

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Complete The Form below to be added to the registry. Please Try to fill in as many spaces as you can and  include all identifying information that would help us in our search at the bottom of the form.
                                      Thanks,
                                            Sherry

Name
Current Address
City
State
Zip Code
E-Mail Address
Phone
You Are?
You Are Searching For?
Adoptee Birthdate
Birth Hospital
Birth City
Birth State
Agency or Attorney
Identifying information
  

If you have troubles with this form or any Questions feel free to e-mail us.

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