CWCMP Office Address: Supervisor: Phone: Email: Case Manager: Phone: Email: Support Worker (if applicable): Phone: Email: Current Caregiver/Placement: Name: Child
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5310.pdf
Date of Birth: Cell Phone: ( ) E-mail: Cell Phone: ( ) E-mail: Race/Ethnicity: (check all that apply
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5320.pdf
Inter Ethnic Placement Act (MEPA/IEPA
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Policy_and_Procedure_Manual.pdfView duplicates
State of Kansas Department for Children and Families Prevention and
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Email Address
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Registrar’s Office: Please email this form to the Kansas DCF Administration Office at
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(EMAIL ONLY
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_7000_Forms/PPS7260.pdf
This is your application for Foster Care Child Care (FC-CC) offered through the Department for
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E-mail: Provide
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https://www.dcf.ks.gov/services/PPS/Documents/FC-CC Application.pdf
questions shall be answered and distributed via E-mail by the agency contact person to all
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be submitted by each interested Contractor via e-mail (preferred) or fax by the close date
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https://www.dcf.ks.gov/Agency/Operations/Documents/OGC/TPRguidelines.pdf
THIS AGENCY HAS BEEN APPROVED BY THE KBI TO SUBMIT FINGERPRINTS ELECTRONICALLY
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PLEASE SUBMIT COMPLETED FINGERPRINT SUBMISSION VIA LIVESCAN
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Failure to follow instructions may result in
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https://www.dcf.ks.gov/Agency/Operations/Documents/OBI/LEA-DCF Forms.pdf
SHANNON CONNELL, FOOD SECURITY AND UTILITY ASSISTANCE DIRECTOR
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out by teams in 36 service centers
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Economic and Employment Services (EES) provides a variety of programs that can help
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https://www.dcf.ks.gov/Agency/Testimony/Documents/2023/1.19 H WF DCF SNAP.pdf
FP-1020 10/21 Page 1 of 1
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Kansas Department for Children and Families
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Instructions: *REQUIRED FIELDS Please Fill in ALL Lines on this Form
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*Have You ever been fingerprinted for DCF
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FP-1020 With Waiver.pdf
Child in the Home or Pregnant Woman
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Economic and Employment Services (EES) provides a variety of programs that
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Email with Client Name and KEES Case Number Sent to Appropriate Mailbox
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https://www.dcf.ks.gov/Agency/Testimony/Documents/2023/1.26 H WF Employment Jobs Programs.pdf