Your Current Name: Your Telephone: Your Street Address: Your City/State/Zip: Birth
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your identifying information (name, address, email address and/or telephone numbers), do not
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_0000_Forms/PPS0335.doc
Department for Children and Families IS-4315
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Email: Gender
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TANF $ per month Medical SSI
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Child Care Plan in Place SSDI $ per month
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CN Email
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https://content.dcf.ks.gov/EES/KEESM/Forms/IS-4315EmploymentServicesReferraltoVocationalRehabilitation08-21.docxView duplicates
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
Is there anything from the last visit that’s still a problem
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Is there anything about which I want my worker to know and/or help
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□ I have my workers phone and email information
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_3000_Forms/PPS3061.doc
Pre-ETS Email and Phone Number
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Student’s email
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Parent/Guardian’s email
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Student’s accommodations/auxiliary aid needs or food allergies if applicable
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If you do not accept the referral the
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https://www.dcf.ks.gov/services/RS/Documents/service_descriptions/EmpowerME_referral2.docx
☐ Attach and email all forms to the grantee/provider, regional Family First mailbox and your
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Use the email subject line: FF_county abbreviation_Lastname_Firstname_4310_Closure
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS4310.docx
Referral for Permanent Custodianship Subsidy Checklist
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This checklist guides the CWCMP through referring a family to receive
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Case Management Provider Contact Agency: Name: Email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6149.docx
Provider: Assigned Provider Staff: Phone: Email: Date Aftercare started: Agreement in
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Frequency and method of contacts between case manager and child/family
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_3000_Forms/PPS3070.doc
Monthly invoices reporting line-item expenses for the invoiced month will be due by the 20th day of the following month
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Grantees will submit invoices and supporting documentation in
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https://www.dcf.ks.gov/services/RS/Documents/OIB_Attachment E.doc
Referral from Pre-ETS to Kansas Workforce Centers
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Pre-ETS Email and Phone Number
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Method Key Staffing is paying the student
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Student’s email
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Parent/Guardian’s email
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Put a checkmark in the box
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https://www.dcf.ks.gov/services/RS/Documents/service_descriptions/WBLreferral_workforce4.docxView duplicates