(Please print and fill out this form and mail it to the address above)

Registrant's Information
_______________________________

Name:_________________________ Telephone: (_ _ _) _ _ _ - _ _ _ _

Email:_________________________ Fax: (_ _ _) _ _ _ - _ _ _ _

Address: (Street, City, Prov, Postal Code) ____________________________________________________

_______________________________________________________________________________________________

You are: Adoptee_____ Birth mother____ Birth Father_____ Other______

IfOther, please specify: ________________________________________


Adoptee's Information
_______________________________

Birth Date:(M/D/Y) (__/__/__) Birth Place:(City, Prov.)______________

Birth Name in full: ___________________________________________

Birth Weight:_______ Hospital:________________ Time of Birth:____________

Adopted or Foster Name in full: ____________________________________

Adopting Parents: _________________________________________________

City Where Adoption was completed: ______________ Date:(M/D/Y) (__/__/__)


 Birth Mother's Information
______________________________________

Name at time of adoptees birth: ______________________________

Birth Date:(M/D/Y) (__/__/__) Birth Place:(City, Prov.)_____________


Birth Father's Information
__________________________________

Name at time of adoptees birth ________________________________

Birth Date:(M/D/Y) (__/__/__)Birth Place:(City, Prov.)________________

If you have your Certificate of Judgement 
or Background Information Sheet, please enclose copies 
(don't send us your originals

Parent Finders PEI is staffed by 
unpaid volunteers - it is not a government agency and does not 
recieve any funding. The registration fee is use to cover operating 
cost only. Services provided are registration and search in the 
computerized Canadian Adoption Reunion Registry (C.A.R.R.), search advice, 
reunion match notification and reunion support.

 * * * All long distance calls will be made to our members collect. * * *


If you move, please be sure to 
advise us of your new address. Many reunion matches have been delayed 
by out-of-date addresses or telephone numbers.

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Other Contact Person  (not someone at the same address)
_________________________________________________________

Name: ________________________ Telephone: (_ _ _) _ _ _ - _ _ _ _

Date: (M/D/Y) (___/___/___) Signature: _______________________

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