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CONTACT INFORMATION

  • 12. Zip Code

  • 13. Date of Birth

  • 14. U.S. citizenship status

    • When does your green card expire? Can you obtain a new one? (Note: we will request legal documentation.)

    • When does your visa expire? Can you obtain a new one? (Note: we will request legal documentation.)

  • 15. What is your ethnic background?

  • 16. Are you a registered member of an American Indian (Native American) tribe?

    • Which tribe? Can you obtain a certified letter from the head of the tribe that they would not make any claim to any child born to you through surrogacy?

  • 17. What is your marital status?

    • When do you anticipate getting married (month and year)?

  • 18. Please list dates of all marriages, if applicable

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  • 19. Please list dates of all divorces, if applicable

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  • 20. If you have a partner or spouse, what is his/her name?

  • 21. Are you religiously affiliated?

    • What is your childhood and current religious affiliation?