1、1附件 2/Annex 2 到儿童福利机构寻根回访接待申请表Welfare Institution Visit Application Form拟回访儿童福利机构名称Name of the Child Welfare Institution to Be Visited拟回访儿童福利机构日期Proposed Date of Visit to the Child Welfare Institution英文姓名English Name性别Sex男 /Male女 /Female出生日期Date of Birth被收养前姓名Original Name收养登记日期Adoption Registration
2、 Date 收养登记证号码Adoption Registration Certificate Number被收养儿童Adopted Child收养登记机关名称Name of the Adoption Registration Authority国籍Nationality姓 名Name性 别Sex出生日期Date of Birth与被收养儿童关系Relationship to the Adopted Child护照号码Passport Number职 业Occupation收养父母Adoptive Parents随行人员Accompanying Person姓 名Name性 别Sex年 龄Age
3、国 籍 Nationality身份证件号码Identity Card Number所在机构Employer翻译人员Interpreter回访要求或回访拟开展的活动Your requirements or proposed activities for this visit联系方式Contact Information电话/Tel: 传真/Fax: 电子邮件/Email:备注:1.申请人应当随申请表提供收养登记证复印件，收养父母、被收养儿童及随行人员护照复印件； 2.所提供联系方式应能够有效接收申请核实结果；3.到儿童福利机构寻根回访接待申请接受单位及联系方式请登录中国儿童福利和收养中心网站:
4、查询。Remarks: 1. The applicant should submit this application form along with a copy of the Adoption Registration Certificate and passport copies of the adoptive parents, adopted child and accompanying person; 2. The contact information provided should be able to receive the application verification results effectively; 3. For the welfare institution visits reception units and their contact information, please visit the website of China Centre for Childrens Welfare and Adoption ( ) for more information
