Form OCFS-5183C OCFS-5183C (4/2018) NEW YORK OFFICE OF CHILDREN AND FAMILY SERVICES APPLICATION TO ADOPT Family Adoption Registry Information NOTE: Select ALL acceptable characteristics. You may choose more than one entry in each area. Sex Under 2 2-5 6-7 8-9 10-13 Over 13 Male Female Other Age: Ethnicity Code: Primary Language Code: Secondary Language Code: Religion Code: ETHNICITY CODE LANGUAGE CODE (FOR CHILD AND PARENTS) (FOR CHILD AND PARENTS) AA ASI AI KM Black or African American Indian Nat Am Lan Cambodian AAC ASJ KR Japanese Albanian Korean AAH ASK AR LA Haitian Korean Arabic Laotian AAN ASX BN MU Native African Other - Asian Bengali Multiple AAX HP BS NI Other - Black or African American Hispanic Bosnian NigeranIbo ML CC PJ Alaskan Native Multiple Cantonese Punjabi AM PI CF PL Native American Native Hawaiian/Pacific Islander Fujianese Polish
Form OCFS-5183C OCFS-5183C (4/2018) NEW YORK OFFICE OF CHILDREN AND FAMILY SERVICES APPLICATION TO ADOPT Family Adoption Registry Information NOTE: Select ALL acceptable characteristics. You may choose more than one entry in each area. Sex Male Female Other Age: Under 2 2-5 6-7 8-9 10-13 Over 13 Ethnicity Code: Primary Language Code: Secondary Language Code: Religion Code: ETHNICITY CODE (FOR CHILD AND PARENTS) LANGUAGE CODE (FOR CHILD AND PARENTS) AA Black or African American ASI Indian AI Nat Am Lan KM Cambodian AAC ASJ Japanese Albanian KR Korean AAH Haitian ASK Korean AR Arabic LA Laotian AAN Native African ASX Other - Asian BN Bengali MU Multiple AAX Other - Black or African American HP Hispanic BS Bosnian NI NigeranIbo Alaskan Native ML Multiple CC Cantonese PJ Punjabi AM Native American PI Native Hawaiian/Pacific Islander CF Fujianese PL Polish
18-OCFS-ADM-07-OCFS-5183.docx