International Post Placement Reports

Please use this form to submit the photos and captions for your India Program post placement reports.

Please note, each photo will need to be under 1 MB to be submitted through this form.

Once you’ve successfully completed your submission, you will be directed to a web page that confirms your photos have been received.

If you have any questions or problems, please email [email protected].

Parent's First & Last Name*
Adopted Child(ren)'s Name(s)*
Email*
Country of Adoption
Attach Document/Photo 1
Max. file size: 1 MB.
Maximum size 1MB.
Photo 1 Caption
Attach Document/Photo 2
Max. file size: 1 MB.
Maximum size 1MB.
Photo 2 Caption
Attach Document/Photo 3
Max. file size: 1 MB.
Maximum size 1MB.
Photo 3 Caption
Attach Document/Photo 4
Max. file size: 1 MB.
Maximum size 1MB.
Photo 4 Caption
Attach Document/Photo 5
Max. file size: 1 MB.
Maximum size 1MB.
Photo 5 Caption
Attach Document/Photo 6
Max. file size: 1 MB.
Maximum size 1MB.
Photo 6 Caption
Attach Document/Photo 7
Max. file size: 1 MB.
Maximum size 1MB.
Photo 7 Caption
Attach Document/Photo 8
Max. file size: 1 MB.
Maximum size 1MB.
Photo 8 Caption
Consent for Release of Information and Images
I give Children's Home Society of Minnesota and Lutheran Social Service of Minnesota the right to use or release the following information for the purposes of post-placement reporting.
Are you willing to be contacted by our staff to request use of these photos in our materials?*
- Yes
- No
Signature (Please type your full legal name to represent your signature.)*

By signing this, I am consenting to the release of the information and items submitted in this form for the purposes of completing post placement reporting. I understand that I will not receive payment for this information. Furthermore, I confirm that I am the individual, or parent/guardian of the individual(s), depicted in the descriptions or images being submitted. My submitting this electronic form amounts to a waiver of any claim I might have whatsoever against CH/LSS and their employees due to the release of information and its subsequent uses.
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Comments
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International Post Placement Reports

Consent for Release of Information and Images

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