Halton CAS Adoption Inquiry

Please note that one applicant must be a Canadian Citizen or Landed Immigrant.  Each applicant must also be a resident of Halton Region.  To send your completed form, click the 'Submit Form' button.
Applicant #1:
Name:
Address:
 
City:
Province:
PostalCode:
Phone (H):
Phone (W):
Phone (C):
E-mail:

Applicant #2:
Name:
Address:
 
City:
Province:
PostalCode:
Phone (H):
Phone (W):
Phone (C):
E-mail:

In making this application, I hereby give permission to Halton Children's Aid Society to contact me via phone, mail or email.

Upon receipt, we will contact you with the date of our next Adoption Information Meeting.