This  information will be used for South Carolina Adoption Reform only

1.  I support the release of the original birth certificate to an adult adoptee at age 21.

     Please Select One:              Yes                  No

2.  Release of non identifying information to every adoptee - regardless of which
      agency handled the adoption at age 18

       Please Select One              Yes                 No
 

Name: First Last:

Address:

City:         St:               Zip:

Email:

Phone:  Area Code   Number

I am (Please select one)  - adoptee adopted parent birth parent birth sibling of the one that was adopted concerned citizen

 If you are an adoptee, adopted parent, birthparent or member of the adopted or birth family
 Did the adoption have a connection with So Carolina ( birth, adoption, termination, adopted/birth parent  location, etc) Yes       No   
 
If you are not a current  resident of  S.C.  where was the location of the birth, adoption, termination, adopted/birth parent  location, etc in S.C.    (city/state)

If you are a resident of the State of SC - are you registered to vote? Yes     No

Can we count on your support for adoption law change in S.C. ?  Yes      Not at this time    

Please give us your comments:  
Would you be a volunteer to work with legislation efforts .