Email
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B. Type of Agency ☐Public ☐Private Non-Profit ☐Private Profit
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C. Official Authorized to Sign Application
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F. Type of Application ☐New ☐Revision ☐Continuation of Grant
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https://www.dcf.ks.gov/services/RS/Documents/OIB_AttachmentA.pdf
Under Federal Grant Award (CFDA) Number 93.558
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Kansas Department for Children and Families
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having a place of business at
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Heartland Regional Alcohol and Drug Assessment Center
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Email
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https://www.dcf.ks.gov/Agency/Operations/NOGA/Documents/HRADAC NOGA SFY22.pdf
FCL 000 03/21 KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES Foster Care Licensing PO Box 1424 Topeka, Kansas 66601-1424 500 SW Van Buren Street 2 nd Floor Topeka, Kansas
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Email: Address
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 000 Release of Compliance History.pdf
RENEWAL#: ': DCF Program may request a Renewal if thay would /ilea lo ,_ a ,nnt for an addHlonal
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Agency: Street Address* City, State, Zip* E-Mail Phone Number Fax.Number jconnections to
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https://www.dcf.ks.gov/Agency/Operations/NOGA/Documents/Connection to Success Renewal 1 FY23.pdf
State, Zip* Grant Year (from/to) E-Mail 7/1/2022 6/30/2024 Phone Number Fiscal Year SFY23
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This form must be submitted to your DCF OGC Grant & Contract Specialist for submission through
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https://www.dcf.ks.gov/Agency/Operations/NOGA/Documents/International Rescue Committee IRC Renewal 1 SFY23.pdf
PRES ENTED TO: SENA TE WA YS & MEA NS SUBCOMMITTEE FE B. 1 1 , 2 0 2 1
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• Kansas Department for Human Services Overview and Budget Summary • Department for Children and Families Overview
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https://www.dcf.ks.gov/Agency/Testimony/Documents/2021/DCF Agency Overview SWAM 21 Session Final.pdf
*physical address required, including 9-digit zip code
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This grant shall remain in effect, subject to the terms and conditions stated in the original Notification of Grant Award
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https://www.dcf.ks.gov/Agency/Operations/NOGA/Documents/Independence Inc CIL Renewal 1 and 2 SFY 23.pdf
State of Kansas Department for Children and Families Prevention and Protection Services FLEX FUND REQUEST
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PPS 4007 January 2015 Page 1
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**SEND ONLY PAGE 1 TO PROVIDER
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EMAIL
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_4000_Forms/PPS4007.pdf
Between Kansas Department for Children and Families
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University of Kansas Medical Center Research Institute, Inc
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**A copy of any previously approved Renewal(s) and/or Amendment(s), as well
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https://www.dcf.ks.gov/Agency/Operations/NOGA/Documents/KU Project Eagle CCP Renewal 1 and 2 SFY23-24.pdf
HI - Home Interview OI - Office Interview CMA - Case Management Activities ET- E-mail To
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From LT - Letter To LF - Letter From EF- E-mail From
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_10000_Forms/PPS10200.pdf