Child Search Ministries

Application/Registration Form

This on-line form will allow you to expedite the assistance Child Search^® may be able to offer.

Incomplete applications will not be processed! denotes a required** field
INFORMATION ABOUT YOU
Your email address^**:
Reporting Parent Full Name^**:
Address^**:
City^**:
State^**:	Use Postal Abbreviation
ZIP/Postal Code^**:
Daytime Phone #^**:	(i.e., (###)###-####)
Collect phone calls:	I accept collect calls to day #.
Evening Phone #^**:	(i.e., (###)###-####)
Collect phone calls:	I accept collect calls to eve #.
FAX #:	(i.e., (###)###-####)
Other Phone #:	(i.e., (###)###-####)
Parent's DOB^**:	DD/MM/YY (i.e., 31/01/95)
Parent's SSN#^**:	as ###-##-####
Legal relationship to child^**:
INFORMATION ABOUT YOUR MISSING CHILD
Type Missing^**:
Full Name of Child^**:
Nickname of Child:
Date of Birth^**:	DD/MM/YY (i.e., 31/01/95)
Height^**:	feet inches
Weight in pounds^**:	lbs.
Child's SSN#^**:	as ###-##-####
Gender^**:
Race^**:
Eye color^**:
Hair color^**:
Body build:
Date Last Seen^**:	DD/MM/YY (i.e., 31/01/95)
Time Last Seen^**:	am pm (i.e., 4:30)
CIRCUMSTANCES
Where & How Child Last Seen (clothing & other items taken, etc): Identifying Marks (scars, tattoos, body piercing, birthmarks, etc): This child is believed to be in the company of (give name, address, vehicle info, description, why thought to be with, etc.): Please note that if you need more than 250 characters for this information (above) please send email to: missing@childsearch.org (with your child's name as the subject)
POLICE REPORT INFORMATION
Police Department Reported to^**:
Police Contact Person^**:
Phone # for Police Contact Person^**:	(i.e., (###)###-####)
Police Case #^**:
*NCIC # or CPIC #^*:
Felony Warrant(s) Issued?	Yes No
If Yes - Against Whom?
Quality Photograph of Child Sent^**:	Attached now: by Mail by Email (scanned .jpg image) to photos@childsearch.org
I am aware that by submitting this application for assistance, I am granting irrevocable rights to Child Search^® to publish photographs of my child, myself, other members of my family and accounts in any form of media both before and after recovery of my child for purposes of locating my child and/or any fund raising or public relations purposes that Child Search^® may have.

If you need to send additional photographs of your child
Please send them to:

Child Search^® Ministries

Attn: Photo Department

P.O. Box 73725
Houston, Texas 77273

To expedite (speed up) assistance, you may email photo(s) in .JPG (JPEG) format to:

photos@childsearch.org

Please remember to list your child's name as the subject of the email.

Child Search^® Ministries is a Christian ministry lifting up the Lord Jesus Christ as the answer to all the challenges of life. Remember that Jesus is the Lord of Lords & King of Kings. May the Lord bless & keep you and yours.

Child Search^® Ministries
P.O. Box 73725
Houston, Texas 77273

Voice: 800-3:16-HOPE (4673)
Fax: 281-320-0055

Comments regarding the website?
<webmaster@childsearch.org>

or

General Child Search^® questions?
<childsearch@childsearch.org>

Website last updated on May 14, 2008

[Home] [Child Search^® Online Database] [Safety Tips]

Amber Alert International 2007 Seal of Approval

Website by: GraffectDesigns.com