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
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
402 State Avenue
Kansas City, KS 66101
Phone: 913-279-7227
Email: Kelly.Milner@ks.gov
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901 Westchester Dr.
Salina, KS 67401
Phone: 785-515-6633
Email: Heather.Koffman@ks.gov
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https://www.dcf.ks.gov/services/RS/Pages/RS_Program_Administrators.aspx
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
State of Kansas PPS 10322a
Department for Children and Families Jun-23
Prevention and Protection Services
Adult Protective Services
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Email
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Finding Due Date if investigation is not
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_10000_Forms/PPS10322a.docx
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
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
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