State of Kansas Department for Children and Families Prevention and Protection Services Appendix 9D July 2015
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Conversion of Intrastate Placement into Interstate Placement; Relocation
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_9D.pdf
How many people live in your household
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Are you responsible for caring for a disabled person daily
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Microsoft TEAMS – Please provide a valid email address for the invitation
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https://content.dcf.ks.gov/EES/KEESM/Appendix/E-6 Self-AssessmentFormFillable.pdfView duplicates
ES-1653 Rev. 4-13 C-15 Page 1 Out of Home Relative Provider Enrollment Thank you for your interest in becoming a DCF child care provider for related
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https://content.dcf.ks.gov/EES/KEESM/Appendix/ES-1653.pdfView duplicates
What are the barriers to the
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Individuals who wish to submit comments in writing may email
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To request a sign language interpreter or other accommodation for the hearing, please email
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https://www.dcf.ks.gov/services/RS/Documents/KRS_Public_Hearing.pdf
Family First Regional Email (check one below
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☐ Attach and email all forms to the grantee/provider, regional Family First mailbox and your
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Use the email subject line
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS4310.pdf
Agency name Agency mailing address Email address: Will return via Encrypted email unless marked otherwise
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/OBI10400 Adult Registry ROI.pdfView duplicates
B. Who is the child in Foster Care being added to or
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This form provides a method to add or remove a child on Foster Care Child
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Phone Email Street Address
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Representative Contact Email
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https://content.dcf.ks.gov/EES/KEESM/Forms/ES-1512FC-CC Change Form.pdfView duplicates
ARCare Trusts and supplemental needs/care trusts are exempt as a resource
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These trusts do not need to be submitted to the Food Assistance Program Manager for TANF or food assistance
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https://content.dcf.ks.gov/EES/KEESM/Appendix/B-6_Request_for_Trust_Annuity_Clearance_05-16.pdfView duplicates
Client email address (if known
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If client has obtained employment in their field of study, please complete
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Copy to: CCDF Program Specialist, Administrative Office
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https://content.dcf.ks.gov/EES/KEESM/Forms/ES-1640a_8_14.pdfView duplicates
Thank you for your interest in
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Telephone Number: Alternate Telephone Number: Email Address: Are you exempt from
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Name: Address: Telephone Number: Fax Number: Email Address
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https://content.dcf.ks.gov/EES/KEESM/Appendix/C-13 ES-1651 Unregulated Child Care Provider Enrollment -DCF.pdfView duplicates