Report a Missing Child Form

Child Protection Education
of America, Inc.
Advocate for America's Missing Children
410 Ware Blvd. Suite 710, Brandon, FL 33511
866-USA-CHILD
813-626-3001

Report a Missing Child Online

This form allows you to send us information on a missing child online. Please fill out the following form and hit the submit button at the bottom. Remember, you need to tab from field to field or click with your mouse. Do not hit the enter or return key. Hitting the Return Key causes the form to submit to us.

Information About the Reporting Parent

Reporting Parent - First Name:

Last Name:

Street Address:

City:

State:

Zip Code:

Home Phone Number w/area code:

Business Phone Number w/area code:

E-Mail Address:

Information About the Missing Child

Missing Child - First Name:

Middle Name:

Last Name:

A.K.A. or Nick Name:

Date of Birth:

Current Age:

Date Missing:

City Missing From:

State Missing From:

Child's Sex:

Child's Height:

Child's Weight in Pounds:

Child's Race:

If other, Describe:

Child's Complexion:

Child's Hair Color:

If other, Specify:

Child's Hair Description:

Length:

Child's Eye Color:

If other, Specify:

Does Child Wear Eyeglasses?

If yes, Describe:

Identifying Marks on the Child (i.e. - tattoo's, piercing, birthmarks, speaking problems, etc.)

Describe Clothing Last Seen Wearing:

Name of Last School Attended:

School Street Address:

School City:

School State:

School Zip Code:

Missing Child Military ID #:

Passport Number - Father:

Passport Number - Mother:

Passport Number - Guardian:

Passport Number - Missing Child:

Information about the Abducting Parent/Person

Abductor's First Name:

Abductor's Middle Name:

Abductor's Last Name:

Abductor's Street Address:

Abductor's City:

Abductor's State:

Abductor's Zip Code:

Abductor's Date of Birth:

Abductor's Hair Color:

If other, Specify:

Abductor's Eye Color:

If other, Specify:

Does Abductor Wear Eyeglasses?

If yes, Describe:

Abductor's Complexion:

Abductor's Height:

Abductor's Weight in Pounds:

Identifying Marks on the Abductor (i.e. - tattoo's, piercing, birthmarks, speaking problems, etc.)

Previous Employer of the Abductor:

Abductor Employer Street Address:

City:

State:

Zip:

Abductor Employer Phone Number w/area code:

Abductor's Automobile ID Number

Abductor's Automobile License Number

Abductor's Warrant For Arrest Number:

Type of Warrant:

Warrant Issued By:

Where?

Date:

Information about the Law Enforcement Agency

Name of Agency:

Agency Street Address:

City:

State:

Zip:

Agency Phone Number:

Officer in Charge:

Child's Case Number

NCIC Number:

Details of The Disappearance: (Be Very Specific)

I/We certify, to the best of my/our knowledge that the above information is correct as shown. I/We give Child Protection Education of America (CPEA) my/our consent to release photographs and other pertinent information of my/our missing child to the public. I understand that this will be done through various means including newspapers, magazines, flyers, television, and other avenues. I/We understand that CPEA does not take the responsibility for returning my/our child to the parent. By hitting the Submit Button, I/We agree to fully release CPEA from any liability, which may result from the actions of the CPEA in the search of my/our child. I/We agree to notify CPEA upon location of my/our child.

If registering a runaway or missing juvenile case, click here for more information.

Todays Date:	as mm/dd/yy
*Report Type:*
*Person Submitting This Report:*
*Relation to the Missing Person:*