☐ 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
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
Your Current Name: Your Telephone: Your Street Address: Your City/State/Zip: Your
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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/PPS0330.doc
Mother’s right’s terminated/relinquished? Yes No Father’s right’s terminated/relinquished? Yes No
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Anticipated date of child’s high school graduation
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6155.doc
State of Kansas Aftercare Contact Agreement for Young Adults PPS 3070A
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Department for Children and Families (For Cases Where Young Adult is not in the Custody of the Secretary
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Email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_3000_Forms/PPS3070A.docx
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
All items are attached to an email and sent to corresponding regional email, including “County.SOUL FAMILY SUBSIDY.Youth
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Follow instructions prompted within email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6300.docx
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
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
If your child is attending school virtually either full or part-time for the 2020-2021 school year
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EES Email
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Save and attach to an email to the office serving the county where you live
https://content.dcf.ks.gov/EES/KEESM/Implem_Memo/Instructions for Submitting Child 2020 School Schedule Form.docxView duplicates