(if different from above): Father’s name
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Name: Address: Phone Number: E-Mail Address: Section VI: Additional Information
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(Email to DCF 30 days prior to the end of aftercare
…
https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_5M.doc
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
…
https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6149.docx
Individuals Determined to Have Achieved an Employment Outcome
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The provision of services under the individual's IPE has contributed to the achievement of the employment outcome
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https://www.dcf.ks.gov/services/RS/Documents/Policy/SEC_5-1.docx
Approved for 4 hours of the
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Contact: Crystal Fox Email: crystal.fox@fosteradopt.org Phone: 913-717-0211 Web: https://www.childally.org/kinship Email: learn@childally.org Phone: (785
…
https://www.dcf.ks.gov/services/PPS/Documents/KinshipResources.pdf
Consumer’s work skills, conditions, preferences and interest
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(Recommend other pertinent consumer information be shared with the provider to assist
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Provider Contact Name: Phone: Email
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https://www.dcf.ks.gov/services/RS/Documents/service_descriptions/Contracts/Section 11 Part-24_Service_referral_form.doc
Section 7 Pre-Employment Transition Services (Pre-ETS
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Protection, use, and release of personal
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or Manager receives a call or email regarding a concern from the Client Assistance Program
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https://www.dcf.ks.gov/services/RS/Documents/Policy/SEC_7-14.docx
DCF REGION: SERVICE COUNTY: PROVIDER: REQUESTOR Name (f, mi., l): SSN: Address
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PPS STAFF NAME: DATE: PHONE: EMAIL: PPS SUPERVISOR AUTHORIZATION: Supervisor or
…
https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_4000_Forms/PPS4007.doc
Telephone # (Cell) City, State Zip: Email address: Permanent Custodians shall use
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Note the following changes and return to the designated office within thirty (30) days of the
…
https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6170.doc
Mailing Address (Street, City, State, Zip Code
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Email
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I/We agree to make monthly payments of $ __per month for consecutive months to complete repayment of the debt
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6180.doc
State of Kansas Department for Children and Families
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As human trafficking legislation is passed, the
…
https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_2A.docx