The number of children and youth in care in Ontario

Adoption Inquiry Form (2014)

Please note, all applicants must be a resident of Halton Region. To send your completed form, click the “Send” button at the bottom of the page.

Fields marked with an asterisk (*) are required.

    Applicant #1

    Full Name*:
    Mothers Birth Last Name:
    Previous/Other Name(s):
    Date of Birth*:
    Street Address*:
    Postal Code*:
    Home Phone*:
    Business Phone:
    Mobile Phone:


    Applicant #2

    Full Name:
    Mothers Birth Last Name:
    Previous/Other Name(s):
    Date of Birth:
    Street Address:
    Postal Code:
    Home Phone:
    Business Phone:
    Mobile Phone:


    Please Note

    The Child Protection Information Network (CPIN) is a province-wide, single information system for all children’s aid societies (CAS) in Ontario. When an individual applies to become an adoptive parent, they will be informed about CPIN. When their identifying information is entered into the system, the CAS checking the provincial database may learn of any previous involvement that person has had with any CAS in Ontario. To continue with the application, the individual will be asked to consent to the collection of their information in CPIN and to a search of the CPIN database. All approved resource parents involved with the Halton Children’s Aid Society will be registered in CPIN. This enables information about adoptive families to be readily available to inform CAS adoption workers and assist in making better matches when placing children and youth.

    I/We acknowledge that I/We have read and understand the information outlined above.

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

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    If you have concerns about a child call:


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    Contact Us

    Burlington Office 1445 Norjohn Court Burlington, ON L7L 0E6
    Milton Office 325 Main Street East Milton, ON L9T 1P5
    Toll Free: 866.607.KIDS (5437) Phone: 905.333.4441 Fax: 905.333.1844 TTY: 711 (TTY to Voice)
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