Tom & Paula Adams’ application to adopt
Monique Bacon

BB-1-qq

FORM B
THE ADOPTION OF CHILDREN ACT
MEDICAL PARTICULARS

1. NAME: Elton Thomas Adams & Paula Adams
2. ADDRESS: Jonestown, Port Kaituma, North West Region, Guyana
3. Is there evidence of infectious disease liable to be contracted by the child? None
4. Does applicant suffer from fits? None
5. In your opinion is the condition of the applicant’s physical or mental health such that he/she should be able to undertake the responsibility and perform the duties of a parent in the event of an adoption order being granted [no answer provided]

Signed [no answer provided]
Qualification [no answer provided]
Address [no answer provided]
Date [no answer provided]

BB-1-rr

APPLICATION TO BOARD

We, the undersigned desire to make application to the Adoption Board in respect of a
Female child, approximately aged 2 yrs 5 months

or the child named Monique Bacon now residing at Jonestown, Port Kaituma, North West Region, Guyana, South America

We hereby undertake that the particulars given below are true to the best of our knowledge and belief.

1. NAMES: Elton Thomas Adams & Paula Adams
2. ADDRESS: Jonestown, Port Kaituma, North West Region, Guyana, South America
3. COUNTRY OF DOMICILE: Guyana
4. DATE OF BIRTH: April 6, 1976
5. RELIGION: Protestant
6. NAMES AND ADDRESSES of two persons able to vouch the character of the adopters. [no answer provided]

/s/ Elton T. Adams
/s/ Paula J. Adams

Originally posted on March 4th, 2022.

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