I. Applicant Information I/We are applying to become an adoptive resource for a
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Applicant 1: Email: Phone: Applicant 2: Email: Phone: Street Address: City, State and Zip
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5316.doc
Department for Children and Families REV 07/2021
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Phone Number and Email for APS Specialist
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We received the attached APS report that a criminal act has occurred or
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Officer Email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_10000_Forms/PPS10120_A.docx
How DCF will support My Plan: Completed by
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I have been part of the decision making and understand that the above agreement requires my participation
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Client Email
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Career Navigator Email
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https://content.dcf.ks.gov/EES/KEESM/Appendix/E-8 TANF Self-Sufficiency Agreement 03-2019_.docxView duplicates
form is to be sent via encrypted email to DCF.SBDT@ks.gov with the client’s home region as
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https://content.dcf.ks.gov/ees/KEESM/Forms/ES-4412_Client_Turn_Around_Form.docView duplicates
You are receiving this notice because there has been an
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Street Address: City: State: Zip Code: Date Sent: Email address
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Cc: Email copy to DCF Central Collections Unit
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6175.doc
Identifying Information: Name of Parent 1: Email Address: Cell Phone #: Name of Parent 2: Email Address: Cell Phone #: Street Address: City
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How did they deal with ended
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5318.doc
Address Home Phone Number Work Phone Number Mobile Number E-Mail Social Security Number
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_7H.doc
Address: Reason: Family new phone/email New Phone/email: Child-only new phone/email New Phone/email: Other Contact Information Change Child's Eligibility
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_9000_Forms/PPS9121.doc
(Check One) Initial Referral Profile Update Today’s Date
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Race/Ethnicity: (check all that apply
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Native Hawaiian or Other Pacific Islander
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Worker Email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5320.docx
Department for Children and Families REV 06/2022
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Email for APS Specialist
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We received the attached APS report that a criminal act has occurred or appeared to have
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Officer Email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_10000_Forms/PPS10120_A .docx