Name of person submitting this client:

First Name

Last Name

Name of adoptee in need: *

First Name

Last Name

What best describes the adoptee:

Korean adoptee

Transracial domestic adoptee

Domestic adoptee

Intercountry Adoptee other than Korean

Other Adoptee

Address of adoptee in need:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone of adoptee in need: *

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TAG CARES CLIENT AND PROVIDER TERMS AND CONDITIONS

1. A TAG Cares Client is independent of The Adoptee Group. The Adoptee Group is not responsible for additional expenses incurred outside of the TAG Cares Award. 2. A TAG Cares Provider is independent of The Adoptee Group. The Adoptee Group is not responsible for the quality or terms of services offered by the provider. 3. TAG agrees to pay a TAG Cares Provider the award following a successful completion of sessions with the TAG Cares Client. The award is in the amount of $500 USD total per client. This fee will be paid in two payments, $250 at the onset of sessions and $250 after the completion of the sessions. An invoice must be submitted for these amounts from the Provider and sent to The Adoptee Group. 4. TAG Cares Provider will receive payment by US check to be mailed to a US address. 5. A TAG Cares Provider may request for their TAG Cares Client to receive one additional award for no more than a total of two awards in one year time period. The award will be granted based on the circumstances and funding available in the TAG Cares program. 6. This agreement may be terminated by either TAG Cares Provider, TAG Cares Client or the Adoptee Group party by providing a written, signed, and dated notice to the other party or parties. 7. Additional terms from the provider or client can be submitted to The Adoptee Group.

YES, I agree to these terms.

NO, I do not agree to these terms.