Your Current Name: Your Telephone: Your Street Address: Your City/State/Zip: Your
…
your identifying information (name, address, email address and/or telephone numbers), do not
…
https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_0000_Forms/PPS0330.doc
DCF is collecting data from youth about independent living services
…
In addition to this current survey, we will offer it to you again when you turn 19 and when you turn 21
…
https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_7C.doc
Department for Children and Families IS-4315
…
Email: Gender
…
TANF $ per month Medical SSI
…
Child Care Plan in Place SSDI $ per month
…
CN Email
…
https://content.dcf.ks.gov/EES/KEESM/Forms/IS-4315EmploymentServicesReferraltoVocationalRehabilitation08-21.docxView duplicates
☐ Attach and email all forms to the grantee/provider, regional Family First mailbox and your
…
Use the email subject line: FF_county abbreviation_Lastname_Firstname_4310_Closure
…
https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS4310.docx
Pre-ETS Email and Phone Number
…
Student’s email
…
Parent/Guardian’s email
…
Student’s accommodations/auxiliary aid needs or food allergies if applicable
…
If you do not accept the referral the
…
https://www.dcf.ks.gov/services/RS/Documents/service_descriptions/EmpowerME_referral2.docx
Mother’s right’s terminated/relinquished? Yes No Father’s right’s terminated/relinquished? Yes No
…
Anticipated date of child’s high school graduation
…
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
…
Department for Children and Families (For Cases Where Young Adult is not in the Custody of the Secretary
…
Email
…
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
…
your identifying information (name, address, email address and/or telephone numbers), do not
…
https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_0000_Forms/PPS0335.doc
Consumer’s work skills, conditions, preferences and interest
…
(Recommend other pertinent consumer information be shared with the provider to assist
…
Provider Contact Name: Phone: Email
…
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
…
Pre-ETS Email and Phone Number
…
Method Key Staffing is paying the student
…
Student’s email
…
Parent/Guardian’s email
…
Put a checkmark in the box
…
https://www.dcf.ks.gov/services/RS/Documents/service_descriptions/WBLreferral_workforce4.docxView duplicates