Date of report

Child's name

Child's first name at birth

(if different from current first name)

Date of birth

Current age

Date of arrival in Australia

Names of family:

Mum

Dad

Brother(s)

Sister(s)

Contact details:

Address

Phone

Email

The Australian Authority involved in the adoption

Date you picked up your child from Ethiopia

About your family life and daily routine

(e.g. diet and eating routine, sleeping habits, and typical day at home)

About your child’s health

(i.e. when she/he last saw a doctor, list any major illness and if she/he has been in hospital, your child's height and weight)

Things you have done to help preserve and celebrate your child's cultural heritage

About your child's Education

(i.e. what class your child is at school, and how your child is progressing at school)

About your child's emotional development

(e.g. about attachment to members of family, about your child's social skills)

About your child's personality

(e.g. what she/he likes/dislikes, what hobbies and activities he/she is involved in)

General development

(motor and language skills, new accomplishments and achievements, e.g. learning to sit up, or ride a bike etc)

Anything else you would like to tell your child's birth-country?

Mum’s signature & date

Dad’s signature & date