JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Origins NSW
Help us fight forced adoption. A newsletter will be forwarded to you at your email address.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Family Name
*
Your answer
Given Name(s)
*
Your answer
Email Address
*
Your answer
Postcode
Your answer
Telephone Number
Your answer
Year you gave birth
*
Your answer
Australian State and City/Town where you gave birth
Your answer
Religious Home, if any, where you were resident prior to giving birth
Your answer
Hospital where you gave birth
*
Your answer
Adoption agency involved
Your answer
Comments relating to the forced adoption of your child and your treatment by State or Religious Authorities
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
